| FORM 3 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year) 10/06/2015 | 3. Issuer Name and Ticker or Trading Symbol FATE THERAPEUTICS INC [ FATE ] | |||||||||||||
| 4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| 5. If Amendment, Date of Original Filed (Month/Day/Year) | ||||||||||||||
6. Individual or Joint/Group Filing (Check Applicable Line)
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| Table I - Non-Derivative Securities Beneficially Owned | |||
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| 1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
| Common Stock | 6,876 | D | |
| Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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| 1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
| Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
| Stock Option (right to buy) | (1) | 02/10/2020 | Common Stock | 2,080 | 1.69 | D | |
| Stock Option (right to buy) | (1) | 03/11/2021 | Common Stock | 8,461 | 1.69 | D | |
| Stock Option (right to buy) | (2) | 01/14/2023 | Common Stock | 2,008 | 1.37 | D | |
| Stock Option ( right to buy) | (3) | 08/12/2023 | Common Stock | 12,309 | 7.87 | D | |
| Stock Option (right to buy) | (4) | 01/09/2024 | Common Stock | 35,000 | 6.62 | D | |
| Stock Option (right to buy) | (5) | 01/05/2025 | Common Stock | 34,560 | 4.84 | D | |
| Explanation of Responses: |
| 1. This option is fully vested. |
| 2. The shares subject to the option shall vest and become exercisable in 48 equal monthly installments beginning on November 1, 2012 such that this option is fully exercisable on October 1, 2016. |
| 3. 1/2 of the shares subject to this option shall vest and become exercisable in 48 equal monthly installments beginning on November 4, 2013, the remaining 1/2 of the shares are divided into five equal parts, each of which will vest and become exercisable in 24 equal monthly installments following the Issuer's achievement of each of five specified performance based milestones. |
| 4. The shares subject to the option shall vest and become exercisable in 48 equal monthly installments beginning on November 4, 2013 such that this option is fully exercisable on October 4, 2017. |
| 5. The shares subject to the option shall vest and become exercisable in 48 equal monthly installments beginning on February 5, 2015 such that this option is fully exercisable on January 5, 2019. |
| Remarks: |
| Exhibit 24 - Power of Attorney |
| /S/Cindy R. Tahl | 10/16/2015 | |
| ** Signature of Reporting Person | Date | |
| Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
| * If the form is filed by more than one reporting person, see Instruction 5 (b)(v). | ||
| ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
| Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
| Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. | ||
