Filing Details

Accession Number:
0001104659-19-041614
Form Type:
4
Zero Holdings:
No
Publication Time:
2019-07-24 16:57:31
Reporting Period:
2019-07-22
Accepted Time:
2019-07-24 16:57:31
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
1366048 Barry Eggers 2200 Sand Hill Road
Menlo Park CA 94025
No No Yes No
1366050 Ravi Mhatre 2200 Sand Hill Road
Menlo Park CA 94025
No No Yes No
1366051 Peter Nieh 2200 Sand Hill Road
Menlo Park CA 94025
No No Yes No
1602573 Lightspeed Venture Partners X, L.p. 2200 Sand Hill Road
Menlo Park CA 94025
No No Yes No
1668017 Lightspeed Venture Partners Select Ii, L.p. 2200 Sand Hill Road
Menlo Park CA 94025
No No Yes No
1700539 Jeremy Liew 2200 Sand Hill Road
Menlo Park CA 94025
No No Yes No
1700549 Lightspeed Ultimate General Partner X, Ltd. 2200 Sand Hill Road
Menlo Park CA 94025
No No Yes No
1700550 Lightspeed General Partner X, L.p. 2200 Sand Hill Road
Menlo Park CA 94025
No No Yes No
1744936 Lightspeed General Partner Select Ii, L.p. 2200 Sand Hill Road
Menlo Park CA 94025
No No Yes No
1744937 Lightspeed Ultimate General Partner Select Ii, Ltd. 2200 Sand Hill Road
Menlo Park CA 94025
No No Yes No
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings Equity Swap Involved Form Type Code Nature of Ownership Explanation
Common Stock Acquisiton 2019-07-22 312,500 $8.00 2,786,868 No 4 P Indirect By Lightspeed Venture Partners X, L.P.
Common Stock Acquisiton 2019-07-22 312,500 $8.00 2,096,769 No 4 P Indirect By Lightspeed Venture Partners Select II, L.P.
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 P Indirect By Lightspeed Venture Partners X, L.P.
No 4 P Indirect By Lightspeed Venture Partners Select II, L.P.
Reported Non-Derivative Holdings
Sec. Name Remaning Holdings Nature of Ownership Explanation
Common Stock 67,036 Indirect By Lightspeed Affiliates X, L.P.
Common Stock 66,743 Indirect By Ravi Mhatre
Common Stock 66,743 Indirect By Mhatre Investments LP - Fund 1
Common Stock 33,372 Indirect By Mhatre 2011 Irrevocable Children's Trust
Common Stock 67,500 Indirect By Peter Nieh
Footnotes
  1. Lightspeed General Partner X, L.P. ("Lightspeed GP X") is the general partner of Lightspeed Venture Partners X, L.P. ("Lightspeed X") and Lightspeed Affiliates X, L.P. ("Lightspeed Affiliates"). Lightspeed Ultimate General Partner X, Ltd. ("Lightspeed UGP X") is the general partner of Lightspeed GP X. Barry Eggers, Jeremy Liew, Ravi Mhatre and Peter Nieh are the directors of Lightspeed UGP X and share voting and dispositive power with respect to the shares held by Lightspeed X and Lightspeed Affiliates. Messrs. Eggers, Liew, Mhatre and Nieh disclaim beneficial ownership of the shares held by Lightspeed X and Lightspeed Affiliates except to the extent of their pecuniary interest therein.
  2. Lightspeed General Partner Select II, L.P. ("Select II GP") is the general partner of Lightspeed Venture Partners Select II, L.P. ("Lightspeed Select II"). Lightspeed Ultimate General Partner Select II, Ltd. ("Select II UGP") is the general partner of Select II GP. Barry Eggers, Jeremy Liew, Ravi Mhatre and Peter Nieh are the directors of Select II UGP and share voting and dispositive power with respect to the shares held by Lightspeed Select II. Messrs. Eggers, Liew, Mhatre and Nieh disclaim beneficial ownership of the shares held by Lightspeed Select II except to the extent of their pecuniary interest therein.
  3. Ravi Mhatre serves as trustee of the general partner of Mhatre Investments LP- Fund 1.
  4. Ravi Mhatre serves as trustee of Mhatre 2011 Irrevocable Children's Trust.