Filing Details

Accession Number:
0001193125-24-036378
Form Type:
13G Filing
Publication Date:
2024-02-13 19:00:00
Filed By:
Kirn David
Company:
4D Molecular Therapeutics Inc. (NASDAQ:FDMT)
Filing Date:
2024-02-14
SEC Url:
13G Filing
Ownership Summary

Please notice the below summary table is generated without human intervention and may contain errors. Please refer to the complete filing displayed below for exact figures.

Name Sole Voting Power Shared Voting Power Sole Dispositive Power Shared Dispositive Power Aggregate Amount Owned Power Percent of Class
David Kirn 2, 0 2, 0 2,033,069 4.7 %
Filing

 

 

United States

Securities and Exchange Commission

Washington, D.C. 20549

 

 

Schedule 13G

(Rule 13d-102)

Information to be Included in Statements Filed Pursuant

to § 240.13d-1(b), (c) and (d) and Amendments Thereto Filed

Pursuant to § 240.13d-2

UNDER THE SECURITIES EXCHANGE ACT OF 1934

(Amendment No. 3)*

 

 

4D Molecular Therapeutics, Inc.

(Name of Issuer)

Common Stock, par value $0.0001

(Title of Class of Securities)

35104E100

(CUSIP Number)

December 31, 2023

(Date of Event Which Requires Filing of this Statement)

 

 

Check the appropriate box to designate the rule pursuant to which this Schedule is filed:

☐ Rule 13d-1(b)

☐ Rule 13d-1(c)

☒ Rule 13d-1(d)

 

*

The remainder of this cover page shall be filled out for a reporting persons initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.

The information required in the remainder of this cover page shall not be deemed to be filed for the purpose of Section 18 of the Securities Exchange Act of 1934 (Act) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).

 

 

 


CUSIP No. 35104E100    Schedule 13G    Page 1 of 4

 

 1   

 Names of Reporting Persons

 

David Kirn

 2  

 Check the Appropriate Box if a Member of a Group

 (a) ☐  (b) ☐

 

 3  

 SEC Use Only

 

 4  

 Citizenship or Place of Organization

 

United States

Number of

Shares  Beneficially 

Owned by

Each

Reporting

Person

With

   5   

 Sole Voting Power

 

2,033,069

   6  

 Shared Voting Power

 

0

   7  

 Sole Dispositive Power

 

2,033,069

   8  

 Shared Dispositive Power

 

0

 9   

 Aggregate Amount Beneficially Owned by Each Reporting Person

 

2,033,069

10  

 Check if the Aggregate Amount in Row (9) Excludes Certain Shares

 

Not Applicable

11  

 Percent of Class Represented by Amount in Row 9

 

4.7%

12  

 Type of Reporting Person

 

IN


CUSIP No. 35104E100    Schedule 13G    Page 2 of 4

 

ITEM 1.

(a) Name of Issuer:

4D Molecular Therapeutics, Inc. (the Issuer).

 

(b) Address of Issuers Principal Executive Offices:

5858 Horton Street #455, Emeryville, CA 94608.

 

ITEM 2.

(a) Name of Person Filing:

This statement is filed on behalf of David Kirn (the Reporting Person).

 

(b) Address or Principal Business Office:

The business address of the Reporting Person is c/o 4D Molecular Therapeutics, Inc., 5858 Horton Street #455, Emeryville, CA 94608.

 

(c) Citizenship of each Reporting Person is:

The Reporting Person is a citizen of the United States.

 

(d) Title of Class of Securities:

Common stock, par value $0.0001 per share (Common Stock).

 

(e) CUSIP Number:

35104E100

 

ITEM 3.

Not applicable.

 

ITEM 4.

Ownership.

The ownership information below represents beneficial ownership of Common Stock of the Issuer as of December 31, 2023, based upon 42,753,607 shares of Common Stock outstanding as of November 2, 2023, as disclosed in the Issuers Quarterly Report on Form 10-Q filed with the Securities and Exchange Commission on November 9, 2023.

 

(a) Amount beneficially owned:

The Reporting Person is the beneficial owner of 2,033,069 shares of Common Stock, which consists of (i) 1,225,819 shares of Common Stock held directly, (ii) 207,250 shares of Common Stock underlying stock options that are currently exercisable or that will become exercisable within 60 days of December 31, 2023 and (iii) 600,000 shares of Common Stock held by family trusts over which the Reporting Person acts as investment advisor.


CUSIP No. 35104E100    Schedule 13G    Page 3 of 4

 

(b) Percent of class: 4.7%

 

(c) Number of shares as to which the person has:

 

  (i)

Sole power to vote or to direct the vote: 2,033,069

 

  (ii)

Shared power to vote or direct the vote: 0

 

  (iii)

Sole power to dispose or to direct the disposition of: 2,033,069

 

  (iv)

Shared power to dispose or to direct the disposition of: 0

 

ITEM 5.

Ownership of Five Percent or Less of a Class.

If this statement is being filed to report the fact that as of the date hereof the Reporting Person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following: ☒

 

ITEM 6.

Ownership of More than Five Percent on Behalf of Another Person.

Not applicable.

 

ITEM 7.

Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company.

Not applicable.

 

ITEM 8.

Identification and Classification of Members of the Group.

Not applicable.

 

ITEM 9.

Notice of Dissolution of Group.

Not applicable.

 

ITEM 10.

Certification.

Not applicable.


CUSIP No. 35104E100    Schedule 13G    Page 4 of 4

 

SIGNATURE

After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.

Date: February 14, 2024

 

David Kirn

/s/ David Kirn