Forty Seven (FTSV) Form 4 Forty Seven / JEFFREY W BIRD ownership change

SEC Form 4

FORM 4

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

1. Name and Address of Reporting Person^*

BIRD JEFFREY W

(Last) (First) (Middle)

755 PAGE MILL ROAD, SUITE A-200

(Street)

PALO ALTO CA 94304-1005

(City) (State) (Zip)

2. Issuer Name and Ticker or Trading Symbol
Forty Seven, Inc. [ FTSV ]

5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	X	10% Owner
	Officer (give title below)		Other (specify below)

3. Date of Earliest Transaction (Month/Day/Year)
07/02/2018

4. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

X	Form filed by One Reporting Person
	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	3. Transaction Code (Instr. 8)		4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5)			5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)	6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
			Code	V	Amount	(A) or (D)	Price
Common Stock	07/02/2018		C		73,686	A	$0(1)	73,686	I	By Ltd Partnership (NEST)(2)
Common Stock	07/02/2018		C		73,159	A	$0(1)	146,845	I	By Ltd Partnership (NEST)(2)
Common Stock	07/02/2018		C		68,530	A	$0(1)	215,375	I	By Ltd Partnership (NEST)(2)
Common Stock	07/02/2018		C		1,052,146	A	$0(1)	1,052,146	I	By Ltd Partnership (SHV)(3)
Common Stock	07/02/2018		C		945,326	A	$0(1)	1,997,472	I	By Ltd Partnership (SHV)(3)
Common Stock	07/02/2018		C		774,165	A	$0(1)	2,771,637	I	By Ltd Partnership (SHV)(3)
Common Stock	07/02/2018		P		134,735	A	$16	2,906,372	I	By Ltd Partnership (SHV)(3)
Common Stock	07/02/2018		P		4,252	A	$16	4,252	I	By Trust(4)
Common Stock	07/02/2018		C		667	A	$0(1)	4,919	I	By Trust(4)

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3)	2. Conversion or Exercise Price of Derivative Security	3. Transaction Date (Month/Day/Year)	3A. Deemed Execution Date, if any (Month/Day/Year)	4. Transaction Code (Instr. 8)		5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)		6. Date Exercisable and Expiration Date (Month/Day/Year)		7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4)		8. Price of Derivative Security (Instr. 5)	9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)	10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
				Code	V	(A)	(D)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares
Series A-1 Preferred Stock	(1)	07/02/2018		C			68,530	(1)	(1)	Common Stock	68,530	(1)	0.0000	I	By Ltd Partnership (NEST)(2)
Series A-2 Preferred Stock	(1)	07/02/2018		C			73,159	(1)	(1)	Common Stock	73,159	(1)	0.0000	I	By Ltd Partnership (NEST)(2)
Series B Preferred Stock	(1)	07/02/2018		C			73,686	(1)	(1)	Common Stock	73,686	(1)	0.0000	I	By Ltd Partnership (NEST)(2)
Series A-1 Preferred Stock	(1)	07/02/2018		C			1,052,146	(1)	(1)	Common Stock	1,052,146	(1)	0.0000	I	By Ltd Partnership (SHV)(3)
Series A-2 Preferred Stock	(1)	07/02/2018		C			774,165	(1)	(1)	Common Stock	774,165	(1)	0.0000	I	By Ltd Partnership (SHV)(3)
Series B Preferred Stock	(1)	07/02/2018		C			945,326	(1)	(1)	Common Stock	945,326	(1)	0.0000	I	By Ltd Partnership (SHV)(3)
Series A-1 Preferred Stock	(1)	07/02/2018		C			667	(1)	(1)	Common Stock	667	(1)	0.0000	I	By Trust(4)

Explanation of Responses:

1. The issuer's preferred stock automatically converted into issuer's common stock on a one-to-one basis immediately upon the closing of the issuer's initial public offering and has no expiration date.

2. Shares held by a limited partnership of which the reporting person is a trustee of a trust which is the general partner. The reporting person disclaims beneficial ownership in these shares except as to the reporting person's pecuniary interest therein.

3. Shares held by Sutter Hill Ventures, a California Limited Partnership. The reporting person is a managing director and member of the management committee of the general partner of Sutter Hill Ventures, a California Limited Partnership. The reporting person disclaims beneficial ownership in these shares except as to the reporting person's pecuniary interest therein.

4. Shares held by a trust of which the reporting person is a trustee. The reporting person disclaims beneficial ownership in these shares except as to the reporting person's pecuniary interest therein.

	/s/ Robert Yin, by power of attorney	07/02/2018
	** 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 4 (b)(v).
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