4D Molecular Therapeutics Inc.

10/10/2025 | Press release | Distributed by Public on 10/10/2025 19:04

Initial Statement of Beneficial Ownership (Form 3)

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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(Print or Type Responses)
1. Name and Address of Reporting Person *
Gupta Ashoo
2. Date of Event Requiring Statement (Month/Day/Year)
09/30/2025
3. Issuer Name and Ticker or Trading Symbol
4D Molecular Therapeutics, Inc. [FDMT]
(Last) (First) (Middle)
C/O 4D MOLECULAR THERAPEUTICS, INC., 5858 HORTON STREET #455
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
__X__ Officer (give title below) _____ Other (specify below)
VP, Finance and Controller
5. If Amendment, Date Original Filed (Month/Day/Year)
(Street)
EMERYVILLE, CA 94608
6. Individual or Joint/Group Filing (Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Beneficially Owned
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 45,662 D
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. SEC 1473 (7-02)
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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 of Derivative Security: 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) 07/08/2034 Common Stock 27,700 $22.69 D
Stock Option (Right to Buy) (2) 03/05/2035 Common Stock 7,056 $4.14 D
Restricted Stock Units (3) (3) Common Stock 13,850 (4) D
Restricted Stock Units (5) (5) Common Stock 3,528 (4) D

Reporting Owners

Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Gupta Ashoo
C/O 4D MOLECULAR THERAPEUTICS, INC.
5858 HORTON STREET #455
EMERYVILLE, CA 94608
VP, Finance and Controller

Signatures

/s/ Ashoo Gupta 10/10/2025
**Signature of Reporting Person Date

Explanation of Responses:

* 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).
(1) 25% of the shares subject to the stock option vest on the first anniversary measured from June 12, 2024 (the "Vesting Commencement Date"), and 1/48th of the total number of shares vest in thirty-six (36) successive and equal monthly installments thereafter, such that 100% of the shares subject to the option will be fully vested and exercisable on the fourth anniversary of the Vesting Commencement Date, while the grantee remains a service provider to the Company.
(2) The shares underlying the stock option award shall vest and become exercisable as to 1/48th of the underlying shares on each monthly anniversary of March 6, 2025 (the "Vesting Commencement Date"), such that 100% of the shares subject to the option will be fully vested and exercisable on the fourth anniversary of the Vesting Commencement Date, while the grantee remains a service provider to the Company.
(3) The shares underlying the restricted stock unit award shall vest as to 25% of the shares on June 20, 2025 and as to 1/16th of the underlying shares on each quarterly anniversary of such date thereafter, while the grantee remains a service provider to the Company.
(4) Each Restricted Stock Unit represents a contingent right to receive one share of Common Stock.
(5) The shares underlying the restricted stock unit award shall vest as to 1/16th of the shares on June 20, 2025 and as to 1/16th of the underlying shares on each quarterly anniversary of such date thereafter, while the grantee remains a service provider to the Company.
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, See Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number.
4D Molecular Therapeutics Inc. published this content on October 10, 2025, and is solely responsible for the information contained herein. Distributed via SEC EDGAR on October 11, 2025 at 01:05 UTC. If you believe the information included in the content is inaccurate or outdated and requires editing or removal, please contact us at [email protected]