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Filing Details

Accession Number:: 0001209191-18-040427
Form Type:: 4
Zero Holdings:: No
Publication Time:: 2018-07-02 17:14:56
Reporting Period:: 2018-07-02

Accepted Time:: 2018-07-02 17:14:56
SEC Url:: Form 4 Filing

Issuer

Cik	Name	Symbol	Sector (SIC)	IRS No
1667633	Forty Seven Inc.	FTSV	()	4

Insiders

Cik	Name	Reported Address	Insider Title	Director	Officer	Large Shareholder	Other
1185068	J Christopher Schaepe	2200 Sand Hill Road Menlo Park CA 94025		Yes	No	Yes	No

Reported Non-Derivative Transactions

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Sec. Name	Acquisiton - Disposition	Date	Amount	Price	Remaning Holdings	Equity Swap Involved	Form Type	Code	Nature of Ownership	Explanation
Common Stock	Acquisiton	2018-07-02	67,036	$0.00	67,036	No	4	C	Indirect	See footnote
Common Stock	Acquisiton	2018-07-02	1,340,698	$0.00	1,340,698	No	4	C	Indirect	See footnote
Common Stock	Acquisiton	2018-07-02	1,133,670	$0.00	2,474,368	No	4	C	Indirect	See footnote
Common Stock	Acquisiton	2018-07-02	1,315,519	$0.00	1,315,519	No	4	C	Indirect	See footnote
Common Stock	Acquisiton	2018-07-02	468,750	$16.00	1,784,269	No	4	P	Indirect	See footnote

Equity Swap Involved	Form Type	Code	Nature of Ownership	Explanation
No	4	C	Indirect	See footnote
No	4	C	Indirect	See footnote
No	4	C	Indirect	See footnote
No	4	C	Indirect	See footnote
No	4	P	Indirect	See footnote

Reported Derivative Transactions

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Sec. Name	Sec. Type	Acquisiton - Disposition	Date	Amount	Price	Amount - 2	Price - 2
Common Stock	Series A-1 Preferred Stock	Disposition	2018-07-02	67,036	$0.00	67,036	$0.00
Common Stock	Series A-1 Preferred Stock	Disposition	2018-07-02	1,340,698	$0.00	1,340,698	$0.00
Common Stock	Series A-2 Preferred Stock	Disposition	2018-07-02	1,133,670	$0.00	1,133,670	$0.00
Common Stock	Series B Preferred Stock	Disposition	2018-07-02	1,315,519	$0.00	1,315,519	$0.00

Equity Swap Involved	Transaction Form Type	Transaction Code	Nature of Ownership
No	4	C	Indirect
No	4	C	Indirect
No	4	C	Indirect
No	4	C	Indirect

Footnotes

The Issuer's preferred stock automatically converted into an equal number of shares of Issuer's common stock immediately upon the closing of the Issuer's initial public offering and has no expiration date.
Shares are held by Lightspeed Affiliates X, L.P., or Lightspeed Affiliates.
Lightspeed General Partner X, L.P., or Lightspeed GP X, is the general partner of Lightspeed X and Lightspeed Affiliates. Lightspeed Ultimate General Partner X, Ltd., or Lightspeed UGP X, is the general partner of Lightspeed GPX. Christopher J. Schaepe, Barry Eggers, Ravi Mhatre, Peter Nieh and Jeremy Liew are the directors of Lightspeed UGP X and share voting and dispositive power with respect to the shares held by Lightspeed X. The Reporting Person disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein.
Shares held by Lightspeed Venture Partners X, L.P., or Lightspeed X.
Shares are held by Lightspeed Venture Partners Select II, L.P., or Lightspeed Select II.
Lightspeed General Partner Select II, L.P., or Select II GP, is the general partner of Lightspeed Select II. Lightspeed Ultimate General Partner Select II, Ltd., or Select II UGP, is the general partner of Select II GP. Mr. Schaepe, Eggers, Mhatre, Nieh and Liew are the directors of Select II UGP and share voting and dispositive power with respect to the shares held by Lightspeed Select II. The Reporting Person disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein.