Fulgent Genetics, Inc. — Director's Dealing 2016

Sep 29, 2016

SEC Form 3 — Initial Statement of Beneficial Ownership

Issuer: Fulgent Genetics, Inc. (FLGT)
CIK: 0001674930
Period of Report: 2016-09-28

Reporting Person: Hsieh Ming (Director, President and CEO, 10% Owner)

Holdings (Non-Derivative)

Security	Shares	Ownership
Issuer Common Stock	1	Direct

Holdings (Derivative)

Security	Exercise Price	Expiration	Underlying	Shares	Ownership
Predecessor Class D-1 Preferred Units	$		Predecessor Class D Voting Common Units (4618421)		Direct
Predecessor Class D-1 Preferred Units	$		Predecessor Class D Voting Common Units (10000000)		Indirect

Footnotes

F1: Reflects securities of Fulgent Therapeutics LLC (the "Predecessor" or "Fulgent LLC"). Fulgent LLC is considered the predecessor of Fulgent Genetics, Inc. (the "Issuer") following completion of a reorganization transaction pursuant to which the Predecessor will become a wholly owned subsidiary of the Issuer (the "Reorganization"), which will be completed on September 30, 2016 in connection with the initial public offering of the Issuer and which is described in the Issuer's Registration Statement on Form S-1, as amended (File No. 333-213469). In the Reorganization, all of the Predecessor's Class D-1 preferred units will be cancelled in exchange for shares of the Issuer's common stock at a ratio of 7.6-for-1.

F2: Prior to the Reorganization, the Predecessor's Class D-1 preferred units had no expiration date and were convertible into the Predecessor's Class D voting common units, on a one-for-one basis and for no additional consideration, at any time at the option of the holder and in connection with an initial public offering of the Predecessor or a successor thereof.

F3: The securities are held of record by the Ming Hsieh Annuity Trust established May 4, 2016 (the "Annuity Trust"), over which Mr. Hsieh possesses sole voting and dispositive power as the sole trustee.