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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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 control number. | SEC 1474 (9-02) |
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 Underlying Securities (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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Stock option (right to buy) (2) | $ 1.54 | 05/16/2016 | A | 200,000 | (3) | 05/15/2026 | Common Stock | 200,000 | (4) | 200,000 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Storgard Chris C/O FATE THERAPEUTICS, INC. 3535 GENERAL ATOMICS COURT, SUITE 200 SAN DIEGO, CA 92121 |
Chief Medical Officer |
/s/ Cindy R. Tahl, as Attorney-in-Fact | 05/18/2016 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(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). |
(1) | Represents shares being issued pursuant to the Company's 2013 Stock Option and Incentive Plan as a portion of a signing bonus in connection with Dr. Storgard's agreement to enter into employment with the Company. |
(2) | This stock option is an inducement grant made under the Company's Inducement Equity Incentive Plan (the "Inducement Plan") pursuant to NASDAQ Stock Market Rule 5635(c)(4). |
(3) | Pursuant to the Inducement Plan, Dr. Storgard was granted an option to buy 200,000 shares of Common Stock. Twenty five percent of the shares subject to this option shall vest and become exercisable on May 16, 2017 and 1/48th of the shares shall vest and become exercisable monthly thereafter, so that one hundred percent of the shares shall be vested and exercisable on May 16, 2020. |
(4) | Not applicable. |