Fulgent Genetics, Inc. Form 4 — Xie Jian (Nov. 7, 2022)

Summary

This Form 4 for Xie Jian, President and COO of Fulgent Genetics, Inc. [ FLGT ], reports two acquisitions on 11/07/2022 tied to the merger of FG Merger Sub, Inc. into Fulgent Pharma Holdings, Inc. under an Agreement and Plan of Merger of that date. Fulgent Pharma RSUs were converted into 129,309 shares of RSUs based on Fulgent Genetics common stock, vesting 25% on October 26, 2022 and 1/16th every three months after, leaving 432,065 shares owned directly. A second line reports 220,816 shares issued to the Hsieh Family Dynasty Trust, dated January 27, 2010, of which 104,098 are in escrow; the filing says Mr. Xie serves on the investment committee of the Trust and disclaims beneficial interest except any pecuniary interest.

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Full text

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 | OMB APPROVAL OMB Number: 3235-0287 Estimated average burden hours per response: 0.5 | OMB APPROVAL | OMB Number: 3235-0287 Estimated average burden hours per response: 0.5 | OMB Number: | 3235-0287 | Estimated average burden | hours per response: | 0.5
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 * Xie Jian (Last) (First) (Middle) C/O FULGENT GENETICS, INC. 4978 SANTA ANITA AVE., STE 205 (Street) TEMPLE CITY CA 91780 (City) (State) (Zip) | Xie Jian | (Last) | (First) | (Middle) | C/O FULGENT GENETICS, INC. | 4978 SANTA ANITA AVE., STE 205 | TEMPLE CITY | CA | 91780 | (City) | (State) | (Zip) | 2. Issuer Name and Ticker or Trading Symbol Fulgent Genetics, Inc. [ FLGT ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable) Director 10% Owner X Officer (give title below) Other (specify below) President and COO | Director | 10% Owner | X | Officer (give title below) | Other (specify below) | President and COO
3. Date of Earliest Transaction
 (Month/Day/Year) 11/07/2022
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 | 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 | 11/07/2022 | A (1) (2) | 129,309 | A | $ 0.00 | 432,065 | D
Common Stock | 11/07/2022 | A (3) | 220,816 | A | $ 0.00 | 220,816 | 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
Explanation of Responses:
1. Pursuant to the Agreement and Plan of Merger, dated as of November 7, 2022 (the "Merger Agreement") by and among Fulgent Genetics, Inc. ("Fulgent Genetics"), FG Merger Sub, Inc. ("FG"), Fulgent Pharma Holdings, Inc. ("Fulgent Pharma"), and the stockholders listed therein, FG merged with and into Fulgent Pharma (the "Merger"), with Fulgent Pharma being the surviving corporation following the Merger. At the effective time of the Merger (the "Effective Time"), each award of restricted stock units ("RSUs") based on Fulgent Pharma common stock that was outstanding immediately prior to the Effective Time ("Fulgent Pharma RSUs") was assumed and converted into the right to receive RSUs based on the common stock of Fulgent Genetics with the same terms and conditions as the Fulgent Pharma RSUs immediately prior to the Effective Time, subject to the applicable exchange ratio.
2. (continued from footnote 1) Twenty-five percent (25%) of the shares subject to RSUs reported herein will vest on the first anniversary of the date of the award, October 26, 2022, and 1/16th of the shares will vest every three months over the remaining 36-month period, subject to continued service for Issuer on each vesting date.
3. At the effective time of the Merger, each issued and outstanding share of Fulgent Pharma preferred stock was converted into 0.02314 shares of Fulgent Genetics common stock, par value $0.0001 per share. Of the 220,816 shares of common stock issued to Hsieh Family Dynasty Trust, dated January 27, 2010 (the "Dynasty Trust") in connection with the Merger, of which 104,098 shares are currently being held in escrow and following the expiration of the indemnification periods set forth in the Merger Agreement, shall be issued pro rata to the Trust in accordance with the terms of the Merger Agreement.
4. Securities held by The Hsieh Family Dynasty Trust, dated January 27, 2010 (the "Trust"). Mr. Xie serves on the investment committee of the Trust. Mr. Xie disclaims any beneficial interest except with respect to any pecuniary interest therein.
Remarks:
/s/ Paul Kim as Attorney-in-Fact | 11/09/2022
** 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).
** 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.

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