Home/Filings/4/0001209191-18-040426

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Clarus Lifesciences III, L.P. 4

Accession 0001209191-18-040426

CIK 0001667633other

View on SEC.gov Company Profile

Filed

Jul 1, 8:00 PM ET

Accepted

Jul 2, 5:14 PM ET

Size

29.7 KB

Accession

0001209191-18-040426

Insider Transaction Report

Form 4

Period: 2018-07-02

Forty Seven, Inc.FTSV

Clarus Lifesciences III, L.P.

10% Owner

Transactions

Purchase
Common Stock
2018-07-02$16.00/sh+200,000$3,200,000→ 3,816,951 total(indirect: See footnote)
Conversion
Common Stock
2018-07-02+938,489→ 938,489 total(indirect: See foonote)
Conversion
Common Stock
2018-07-02+755,780→ 1,694,269 total(indirect: See footnote)
Conversion
Series A-2 Preferred Stock
2018-07-02−755,780→ 0 total(indirect: See foonote)
→ Common Stock (755,780 underlying)
Conversion
Series B Preferred Stock
2018-07-02−1,922,682→ 0 total(indirect: See footnote)
→ Common Stock (1,922,682 underlying)
Conversion
Series A-1 Preferred Stock
2018-07-02−938,489→ 0 total(indirect: See footnote)
→ Common Stock (938,489 underlying)
Conversion
Common Stock
2018-07-02+1,922,682→ 3,616,951 total(indirect: See footnote)

WHEELER KURT

10% Owner

Transactions

Conversion
Common Stock
2018-07-02+1,922,682→ 3,616,951 total(indirect: See footnote)
Purchase
Common Stock
2018-07-02$16.00/sh+200,000$3,200,000→ 3,816,951 total(indirect: See footnote)
Conversion
Series B Preferred Stock
2018-07-02−1,922,682→ 0 total(indirect: See footnote)
→ Common Stock (1,922,682 underlying)
Conversion
Series A-1 Preferred Stock
2018-07-02−938,489→ 0 total(indirect: See footnote)
→ Common Stock (938,489 underlying)
Conversion
Series A-2 Preferred Stock
2018-07-02−755,780→ 0 total(indirect: See foonote)
→ Common Stock (755,780 underlying)
Conversion
Common Stock
2018-07-02+938,489→ 938,489 total(indirect: See foonote)
Conversion
Common Stock
2018-07-02+755,780→ 1,694,269 total(indirect: See footnote)

Clarus Ventures III, LLC

10% Owner

Transactions

Conversion
Common Stock
2018-07-02+938,489→ 938,489 total(indirect: See foonote)
Conversion
Series A-1 Preferred Stock
2018-07-02−938,489→ 0 total(indirect: See footnote)
→ Common Stock (938,489 underlying)
Conversion
Series B Preferred Stock
2018-07-02−1,922,682→ 0 total(indirect: See footnote)
→ Common Stock (1,922,682 underlying)
Conversion
Common Stock
2018-07-02+1,922,682→ 3,616,951 total(indirect: See footnote)
Purchase
Common Stock
2018-07-02$16.00/sh+200,000$3,200,000→ 3,816,951 total(indirect: See footnote)
Conversion
Common Stock
2018-07-02+755,780→ 1,694,269 total(indirect: See footnote)
Conversion
Series A-2 Preferred Stock
2018-07-02−755,780→ 0 total(indirect: See foonote)
→ Common Stock (755,780 underlying)

HENNER DENNIS

Director10% Owner

Transactions

Conversion
Common Stock
2018-07-02+1,922,682→ 3,616,951 total(indirect: See footnote)
Conversion
Common Stock
2018-07-02+938,489→ 938,489 total(indirect: See foonote)
Conversion
Series B Preferred Stock
2018-07-02−1,922,682→ 0 total(indirect: See footnote)
→ Common Stock (1,922,682 underlying)
Purchase
Common Stock
2018-07-02$16.00/sh+200,000$3,200,000→ 3,816,951 total(indirect: See footnote)
Conversion
Series A-1 Preferred Stock
2018-07-02−938,489→ 0 total(indirect: See footnote)
→ Common Stock (938,489 underlying)
Conversion
Common Stock
2018-07-02+755,780→ 1,694,269 total(indirect: See footnote)
Conversion
Series A-2 Preferred Stock
2018-07-02−755,780→ 0 total(indirect: See foonote)
→ Common Stock (755,780 underlying)

GALAKATOS NICHOLAS

10% Owner

Transactions

Conversion
Series A-1 Preferred Stock
2018-07-02−938,489→ 0 total(indirect: See footnote)
→ Common Stock (938,489 underlying)
Purchase
Common Stock
2018-07-02$16.00/sh+200,000$3,200,000→ 3,816,951 total(indirect: See footnote)
Conversion
Series B Preferred Stock
2018-07-02−1,922,682→ 0 total(indirect: See footnote)
→ Common Stock (1,922,682 underlying)
Conversion
Common Stock
2018-07-02+938,489→ 938,489 total(indirect: See foonote)
Conversion
Common Stock
2018-07-02+755,780→ 1,694,269 total(indirect: See footnote)
Conversion
Common Stock
2018-07-02+1,922,682→ 3,616,951 total(indirect: See footnote)
Conversion
Series A-2 Preferred Stock
2018-07-02−755,780→ 0 total(indirect: See foonote)
→ Common Stock (755,780 underlying)

LIPTAK ROBERT

10% Owner

Transactions

Conversion
Common Stock
2018-07-02+938,489→ 938,489 total(indirect: See foonote)
Conversion
Common Stock
2018-07-02+1,922,682→ 3,616,951 total(indirect: See footnote)
Purchase
Common Stock
2018-07-02$16.00/sh+200,000$3,200,000→ 3,816,951 total(indirect: See footnote)
Conversion
Series A-2 Preferred Stock
2018-07-02−755,780→ 0 total(indirect: See foonote)
→ Common Stock (755,780 underlying)
Conversion
Common Stock
2018-07-02+755,780→ 1,694,269 total(indirect: See footnote)
Conversion
Series A-1 Preferred Stock
2018-07-02−938,489→ 0 total(indirect: See footnote)
→ Common Stock (938,489 underlying)
Conversion
Series B Preferred Stock
2018-07-02−1,922,682→ 0 total(indirect: See footnote)
→ Common Stock (1,922,682 underlying)

Simon Nicholas

10% Owner

Transactions

Conversion
Common Stock
2018-07-02+755,780→ 1,694,269 total(indirect: See footnote)
Purchase
Common Stock
2018-07-02$16.00/sh+200,000$3,200,000→ 3,816,951 total(indirect: See footnote)
Conversion
Common Stock
2018-07-02+1,922,682→ 3,616,951 total(indirect: See footnote)
Conversion
Series A-1 Preferred Stock
2018-07-02−938,489→ 0 total(indirect: See footnote)
→ Common Stock (938,489 underlying)
Conversion
Series A-2 Preferred Stock
2018-07-02−755,780→ 0 total(indirect: See foonote)
→ Common Stock (755,780 underlying)
Conversion
Common Stock
2018-07-02+938,489→ 938,489 total(indirect: See foonote)
Conversion
Series B Preferred Stock
2018-07-02−1,922,682→ 0 total(indirect: See footnote)
→ Common Stock (1,922,682 underlying)

Requadt Scott

10% Owner

Transactions

Conversion
Series A-2 Preferred Stock
2018-07-02−755,780→ 0 total(indirect: See foonote)
→ Common Stock (755,780 underlying)
Conversion
Common Stock
2018-07-02+755,780→ 1,694,269 total(indirect: See footnote)
Conversion
Series B Preferred Stock
2018-07-02−1,922,682→ 0 total(indirect: See footnote)
→ Common Stock (1,922,682 underlying)
Purchase
Common Stock
2018-07-02$16.00/sh+200,000$3,200,000→ 3,816,951 total(indirect: See footnote)
Conversion
Series A-1 Preferred Stock
2018-07-02−938,489→ 0 total(indirect: See footnote)
→ Common Stock (938,489 underlying)
Conversion
Common Stock
2018-07-02+938,489→ 938,489 total(indirect: See foonote)
Conversion
Common Stock
2018-07-02+1,922,682→ 3,616,951 total(indirect: See footnote)

Clarus Ventures III GP, L.P.

10% Owner

Transactions

Conversion
Series A-2 Preferred Stock
2018-07-02−755,780→ 0 total(indirect: See foonote)
→ Common Stock (755,780 underlying)
Conversion
Series B Preferred Stock
2018-07-02−1,922,682→ 0 total(indirect: See footnote)
→ Common Stock (1,922,682 underlying)
Conversion
Common Stock
2018-07-02+938,489→ 938,489 total(indirect: See foonote)
Conversion
Series A-1 Preferred Stock
2018-07-02−938,489→ 0 total(indirect: See footnote)
→ Common Stock (938,489 underlying)
Conversion
Common Stock
2018-07-02+755,780→ 1,694,269 total(indirect: See footnote)
Conversion
Common Stock
2018-07-02+1,922,682→ 3,616,951 total(indirect: See footnote)
Purchase
Common Stock
2018-07-02$16.00/sh+200,000$3,200,000→ 3,816,951 total(indirect: See footnote)

Footnotes (2)

[F1]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.
[F2]Clarus Ventures III GP, LP, or GPLP, as the sole general partner of Clarus Lifesciences III, LP, or Clarus, may be deemed to beneficially own certain of the shares held by Clarus. GPLP disclaims beneficial ownership of all shares held by Clarus in which the GPLP does not have a pecuniary interest. Clarus Ventures III, LLC, or GPLLC, as the sole general partner of the GPLP, may be deemed to beneficially own certain of the shares held by Clarus. GPLLC disclaims beneficial ownership of all shares held by Clarus in which it does not have an actual pecuniary interest. Each of Dennis Henner, Nicholas Galakatos, Robert Liptak, Nicholas Simon, Scott Requadt and Kurt Wheeler, as individual managing directors of GPLLC, may be deemed to beneficially own certain of the shares held of record by Clarus. Dr. Henner and Messrs. Galakatos, Liptak, Simon, Requadt and Wheeler disclaims beneficial ownership of all shares held of record by Clarus in which they do not have an actual pecuniary interest.

Documents

1 file

4
doc4.xmlPrimary
FORM 4 SUBMISSION

Issuer

Forty Seven, Inc.

CIK 0001667633

→

Entity typeother

IncorporatedDE

Related Parties

filerCIK 0001597143

Filing Metadata

Form type: 4
Filed: Jul 1, 8:00 PM ET
Accepted: Jul 2, 5:14 PM ET
Size: 29.7 KB

View on SEC.gov