0001209191-16-152160.txt : 20161128 0001209191-16-152160.hdr.sgml : 20161128 20161128154631 ACCESSION NUMBER: 0001209191-16-152160 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161123 FILED AS OF DATE: 20161128 DATE AS OF CHANGE: 20161128 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FATE THERAPEUTICS INC CENTRAL INDEX KEY: 0001434316 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3535 GENERAL ATOMICS COURT STREET 2: SUITE 200 CITY: SAN DIEGO STATE: CA ZIP: 92121 BUSINESS PHONE: 858.875.1803 MAIL ADDRESS: STREET 1: 3535 GENERAL ATOMICS COURT STREET 2: SUITE 200 CITY: SAN DIEGO STATE: CA ZIP: 92121 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Storgard Chris CENTRAL INDEX KEY: 0001674703 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36076 FILM NUMBER: 162019845 MAIL ADDRESS: STREET 1: C/O FATE THERAPEUTICS, INC. STREET 2: 3535 GENERAL ATOMICS COURT, STE 200 CITY: SAN DIEGO STATE: CA ZIP: 92121 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2016-11-23 0 0001434316 FATE THERAPEUTICS INC FATE 0001674703 Storgard Chris C/O FATE THERAPEUTICS, INC. 3535 GENERAL ATOMICS COURT, SUITE 200 SAN DIEGO CA 92121 0 1 0 0 Chief Medical Officer Common Stock 2016-11-23 4 P 0 37593 2.66 A 37593 I By The Storgard Family Trust, June 28, 2012 Common Stock 9090 D Represents shares acquired in a private placement pursuant to the Securities Purchase Agreement dated November 21, 2016 by and among the issuer and the purchasers named therein. These shares are owned of record by The Storgard Family Trust, June 28, 2012 for which Chris M. Storgard and Melinda Storgard are co-trustees. /s/ Cindy R. Tahl, as Attorney-in-Fact 2016-11-28