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
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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*
POLARIS VENTURE MANAGEMENT CO III LLC

(Last) (First) (Middle)
1000 WINTER STREET
SUITE 3350

(Street)
WALTHAM MA 02451-1215

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
MOMENTA PHARMACEUTICALS INC [ MNTA ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
06/27/2005
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X 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 06/27/2005 J(1) 2,879,734 D (3) 1,743,132 I(4) by Polaris Venture Partners III, L.P.
Common Stock 06/27/2005 J(2) 74,840 D (3) 45,301 I(4) by Polaris Venture Partners Entrepreneurs' Fund III, L.P.
Common Stock 06/27/2005 J(5) 45,426 D (3) 27,497 I(4) by Polaris Venture Partners Founders' Fund III, L.P.
Common Stock 06/27/2005 J(5) 450 A (3) 1,816,380 D(4)
Common Stock 06/27/2005 J(5) 365(6) A (3) 1,816,745 D(4)
Common Stock 06/27/2005 J(2) 369(7) A (3) 1,816,749 D(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
1. Name and Address of Reporting Person*
POLARIS VENTURE MANAGEMENT CO III LLC

(Last) (First) (Middle)
1000 WINTER STREET
SUITE 3350

(Street)
WALTHAM MA 02451-1215

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
POLARIS VENTURE PARTNERS III LP

(Last) (First) (Middle)
1000 WINTER STREET
SUITE 3350

(Street)
WALTHAM MA 02451-1215

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
POLARIS VENTURE PARTNERS FOUNDERS FUND III LP

(Last) (First) (Middle)
1000 WINTER STREET
SUITE 3350

(Street)
WALTHAM MA 02451-1215

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
POLARIS VENTURE PARTNERS ENTREPRENEURS FUND III LP

(Last) (First) (Middle)
1000 WINTER STREET
SUITE 3350

(Street)
WALTHAM MA 02451-1215

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Arnold Stephen D

(Last) (First) (Middle)
1000 WINTER STREET
SUITE 3350

(Street)
WALTHAM MA 02451-1215

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Flint Jonathan A

(Last) (First) (Middle)
1000 WINTER STREET
SUITE 3350

(Street)
WALTHAM MA 02451-1215

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
MCGUIRE TERRANCE

(Last) (First) (Middle)
1000 WINTER STREET
SUITE 3350

(Street)
WALTHAM MA 02451-1215

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
SPOON ALAN G

(Last) (First) (Middle)
1000 WINTER STREET
SUITE 3350

(Street)
WALTHAM MA 02451-1215

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
1. Pro-rata distribution in kind without consideration to the general and limited partners of Polaris Venture Partners III, L.P. , a partnership ("PVP III") of which the Designated Filer, Polaris Venture Management Co. III, L.L.C. ("PVM III"), is the general partner. PVM III disclaims beneficial ownership of shares held by PVP III except to the extent of any pecuniary interest therein.
2. Pro-rata distribution in kind without consideration to the general and limited partners of Polaris Venture Partners Entrepreneurs' Fund III, L.P., a partnership ("PVPEF III") of which the Designated Filer, PVM III, is the general partner. PVM III disclaims beneficial ownership of shares held by PVPEF III except to the extent of any pecuniary interest therein.
3. N/A
4. Jonathan A. Flint, Terrance G. McGuire, Alan G. Spoon and Stephen D. Arnold, the managing members of the Designated Filer, PVM III, may be deemed to share voting and dispositive power over shares held by PVM III. Such persons disclaim beneficial ownership of shares held by PVM III except to the extent of any indirect pecuniary interest therein.
5. Pro-rata distribution in kind without consideration to the general and limited partners of Polaris Venture Partners Founders' Fund III, L.P., a partnership ("PVPFF III") of which PVM III is the general partner. PVM III disclaims beneficial ownership of shares held by PVPFF III except to the extent of any pecuniary interest therein.
6. These shares are owned directly by Stephen D. Arnold.
7. These shares are owned directly by Jonathan A. Flint.
/s/ Kevin Littlejohn, Authorized Signatory 06/29/2005
** 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).
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