-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, INQhLj3YGlfyVYKCjgUv80g4BWOocyu9ghw3bJy0UsRqKNqAMz51W5kjtfMvwFYj k7sU9Y3vlcpOuYwUzZDvYg== 0000950135-05-000745.txt : 20050214 0000950135-05-000745.hdr.sgml : 20050214 20050214154734 ACCESSION NUMBER: 0000950135-05-000745 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20050214 DATE AS OF CHANGE: 20050214 GROUP MEMBERS: ALAN G. SPOON GROUP MEMBERS: JONATHAN A. FLINT GROUP MEMBERS: POLARIS VENTURE MANAGEMENT CO. III, L.L.C. GROUP MEMBERS: POLARIS VENTURE PARTNERS ENTREPENEURS' FUND III, L.P. GROUP MEMBERS: POLARIS VENTURE PARTNERS FOUNDERS' FUND III, L.P. GROUP MEMBERS: STEPHEN D. ARNOLD GROUP MEMBERS: TERRANCE G. MCGUIRE SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: MOMENTA PHARMACEUTICALS INC CENTRAL INDEX KEY: 0001235010 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 043561634 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-79927 FILM NUMBER: 05609665 BUSINESS ADDRESS: STREET 1: 43 MOULTON STREET CITY: CAMBRIDGE STATE: MA ZIP: 02138 BUSINESS PHONE: 6174919700 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: POLARIS VENTURE PARTNERS III LP CENTRAL INDEX KEY: 0001104639 IRS NUMBER: 043497143 FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: 1000 WINTER STREET STREET 2: SUITE 3350 CITY: WALLTHAM STATE: MA ZIP: 02451-1215 BUSINESS PHONE: 7812900770 MAIL ADDRESS: STREET 1: 1000 WINTER STREET STREET 2: SUITE 3350 CITY: WALTHAM STATE: MA ZIP: 02451 SC 13G 1 b53539mpsc13g.txt MOMENTA PHARMACEUTICALS, INC. FORM SC 13G SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 Schedule 13G (Rule 13d-102) INFORMATION TO BE INCLUDED IN STATEMENTS FILED PURSUANT TO RULES 13d-1 (b), (c) AND (d) AND AMENDMENTS THERETO FILED PURSUANT TO 13d-2 (b) Momenta Pharmaceuticals, Inc. (Name of Issuer) Common Stock (Title of Class of Securities) 60877T101 (CUSIP Number) December 31, 2004 (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) [X] Rule 13d-1(d) * The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures provided in a prior cover page. The information required on 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). (Continued on following pages) Page 1 of 18 Exhibit Index on Page 15 CUSIP NO. 60877T101 13 G Page 2 of 18 - -------------------------------------------------------------------------------- 1 NAME OF REPORTING SS OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON Polaris Venture Partners III, L.P. ("PVP III") Tax ID Number: - -------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [ ] (b) [X] - -------------------------------------------------------------------------------- 3 SEC USE ONLY - -------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION Delaware - -------------------------------------------------------------------------------- 5 SOLE VOTING POWER 4,863,016 shares, except that Polaris Venture Management Co. III, L.L.C. ("Polaris III"), the general partner of PVP III, may be deemed to have sole power to vote these shares, and Jonathan A. Flint ("Flint"), Terrance G. McGuire ("McGuire"), Stephen D. Arnold ("Arnold") and Alan G. Spoon ("Spoon"), the managing members of Polaris III, may be deemed to have shared NUMBER OF power to vote these shares. SHARES ----------------------------------------------------------------- BENEFICIALLY 6 SHARED VOTING POWER OWNED BY EACH See response to row 5. REPORTING ----------------------------------------------------------------- PERSON 7 SOLE DISPOSITIVE POWER WITH 4,863,016 shares, except that Polaris III, the general partner of PVP III, may be deemed to have sole power to dispose of these shares, and Flint, McGuire, Arnold and Spoon, the managing members of Polaris III, may be deemed to have shared power to dispose of these shares. ----------------------------------------------------------------- 8 SHARED DISPOSITIVE POWER See response to row 7. - -------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 4,863,016 - -------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* [ ] - -------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 19.1% - -------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* PN - -------------------------------------------------------------------------------- CUSIP NO. 60877T101 13 G Page 3 of 18 - -------------------------------------------------------------------------------- 1 NAME OF REPORTING SS OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON Polaris Venture Partners Entrepreneurs' Fund III, L.P. ("Entrepreneurs' III") Tax ID Number: - -------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [ ] (b) [X] - -------------------------------------------------------------------------------- 3 SEC USE ONLY - -------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION Delaware - -------------------------------------------------------------------------------- 5 SOLE VOTING POWER 126,266 shares, except that Polaris III, the general partner of Entrepreneurs' III, may be deemed to have sole power to vote these shares, and Flint, McGuire, Arnold and Spoon, the managing members of Polaris III, may be deemed to have shared power to vote these shares. NUMBER OF ----------------------------------------------------------------- SHARES 6 SHARED VOTING POWER BENEFICIALLY OWNED BY See response to row 5. EACH ----------------------------------------------------------------- REPORTING 7 SOLE DISPOSITIVE POWER PERSON WITH 126,266 shares, except that Polaris III, the general partner of Entrepreneurs' III, may be deemed to have sole power to dispose of these shares, and Flint, McGuire, Arnold and Spoon, the managing members of Polaris III, may be deemed to have shared power to dispose of these shares. ----------------------------------------------------------------- 8 SHARED DISPOSITIVE POWER See response to row 7. - -------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 126,266 - -------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* [ ] - -------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 0.5% - -------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* PN - -------------------------------------------------------------------------------- CUSIP NO. 60877T101 13 G Page 4 of 18 - -------------------------------------------------------------------------------- 1 NAME OF REPORTING SS OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON Polaris Venture Partners Founders' Fund III, L.P. ("Founders' III") Tax ID Number: - -------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [ ] (b) [X] - -------------------------------------------------------------------------------- 3 SEC USE ONLY - -------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION Delaware - -------------------------------------------------------------------------------- 5 SOLE VOTING POWER 76,648 shares, except that Polaris III, the general partner of Founders' III, may be deemed to have sole power to vote these shares, and Flint, McGuire, Arnold and Spoon, the managing members of Polaris III, may be deemed to have shared power to vote these shares. NUMBER OF ----------------------------------------------------------------- SHARES 6 SHARED VOTING POWER BENEFICIALLY OWNED BY See response to row 5. EACH ----------------------------------------------------------------- REPORTING 7 SOLE DISPOSITIVE POWER PERSON WITH 76,648 shares, except that Polaris III, the general partner of Founders' III, may be deemed to have sole power to dispose of these shares, and Flint, McGuire, Arnold and Spoon, the managing members of Polaris III, may be deemed to have shared power to dispose of these shares. ----------------------------------------------------------------- 8 SHARED DISPOSITIVE POWER See response to row 7. - -------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 76,648 - -------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9)EXCLUDES CERTAIN SHARES* [ ] - -------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 0.3% - -------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* PN - -------------------------------------------------------------------------------- CUSIP NO. 60877T101 13 G Page 5 of 18 - -------------------------------------------------------------------------------- 1 NAME OF REPORTING SS OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON Polaris Venture Management Co. III, L.L.C. ("Polaris III") Tax ID Number: - -------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [ ] (b) [X] - -------------------------------------------------------------------------------- 3 SEC USE ONLY - -------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION Delaware - -------------------------------------------------------------------------------- 5 SOLE VOTING POWER 5,065,930 shares, of which 4,863,016 are directly owned by PVP III, 126,266 are directly owned by Entrepreneurs' III and 76,648 are directly owned by Founders' III. Polaris III, the general partner of PVP III, Entrepreneurs' III and Founders' III, may be deemed to have sole power to vote these shares, and Flint, McGuire, Arnold and Spoon, the managing members of Polaris III, may be deemed to have shared power to vote these shares. ----------------------------------------------------------------- NUMBER OF 6 SHARED VOTING POWER SHARES BENEFICIALLY See response to row 5. OWNED BY ----------------------------------------------------------------- EACH 7 SOLE DISPOSITIVE POWER REPORTING PERSON 5,065,930 shares, of which 4,863,016 are directly owned by WITH PVP III, 126,266 are directly owned by Entrepreneurs' III and 76,648 are directly owned by Founders' III. Polaris III, the general partner of PVP III, Entrepreneurs' III and Founders' III, may be deemed to have sole power to dispose of these shares, and Flint, McGuire, Arnold and Spoon, the managing members of Polaris III, may be deemed to have shared power to dispose of these shares. ----------------------------------------------------------------- 8 SHARED DISPOSITIVE POWER See response to row 7. - -------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 5,065,930 - -------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9)EXCLUDES CERTAIN SHARES* [ ] - -------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 19.9% - -------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* OO - -------------------------------------------------------------------------------- CUSIP NO. 60877T101 13 G Page 6 of 18 - -------------------------------------------------------------------------------- 1 NAME OF REPORTING SS OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON Jonathan A. Flint ("Flint") Tax ID Number: - -------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [ ] (b) [X] - -------------------------------------------------------------------------------- 3 SEC USE ONLY - -------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION U.S. Citizen - -------------------------------------------------------------------------------- 5 SOLE VOTING POWER 0 shares. ----------------------------------------------------------------- 6 SHARED VOTING POWER 5,065,930 shares, of which 4,863,016 are directly owned by PVP III, 126,266 are directly owned by Entrepreneurs' III and 76,648 are directly owned by Founders' III. Polaris III is the general partner of PVP III, Entrepreneurs' III and NUMBER OF Founders' III. Flint is a managing member of Polaris III, SHARES and may be deemed to have shared power to vote these BENEFICIALLY shares. OWNED BY ----------------------------------------------------------------- EACH 7 SOLE DISPOSITIVE POWER REPORTING PERSON 0 shares. WITH ----------------------------------------------------------------- 8 SHARED DISPOSITIVE POWER 5,065,930 shares, of which 4,863,016 are directly owned by PVP III, 126,266 are directly owned by Entrepreneurs' III and 76,648 are directly owned by Founders' III. Polaris III is the general partner of PVP III, Entrepreneurs' III and Founders' III. Flint is a managing member of Polaris III, and may be deemed to have shared power to dispose of these shares. - -------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 5,065,930 - -------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* [ ] - -------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 19.9% - -------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* IN - -------------------------------------------------------------------------------- CUSIP NO. 60877T101 13 G Page 7 of 18 - -------------------------------------------------------------------------------- 1 NAME OF REPORTING SS OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON Terrance G. McGuire ("McGuire") Tax ID Number: - -------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [ ] (b) [X] - -------------------------------------------------------------------------------- 3 SEC USE ONLY - -------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION U.S. Citizen - -------------------------------------------------------------------------------- 5 SOLE VOTING POWER 0 shares. ----------------------------------------------------------------- 6 SHARED VOTING POWER 5,065,930 shares, of which 4,863,016 are directly owned by PVP III, 126,266 are directly owned by Entrepreneurs' III and 76,648 are directly owned by Founders' III. Polaris III is the general partner of PVP III, Entrepreneurs' III and NUMBER OF Founders' III. McGuire is a managing member of Polaris III, SHARES and may be deemed to have shared power to vote these BENEFICIALLY shares. OWNED BY ----------------------------------------------------------------- EACH 7 SOLE DISPOSITIVE POWER REPORTING PERSON 0 shares. WITH ----------------------------------------------------------------- 8 SHARED DISPOSITIVE POWER 5,065,930 shares, of which 4,863,016 are directly owned by PVP III, 126,266 are directly owned by Entrepreneurs' III and 76,648 are directly owned by Founders' III. Polaris III is the general partner of PVP III, Entrepreneurs' III and Founders' III. McGuire is a managing member of Polaris III, and may be deemed to have shared power to dispose of these shares. - -------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 5,065,930 - -------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* [ ] - -------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 19.9% - -------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* IN - -------------------------------------------------------------------------------- CUSIP NO. 60877T101 13 G Page 8 of 18 - -------------------------------------------------------------------------------- 1 NAME OF REPORTING SS OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON Stephen D. Arnold ("Arnold") Tax ID Number: - -------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [ ] (b) [X] - -------------------------------------------------------------------------------- 3 SEC USE ONLY - -------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION U.S. Citizen - -------------------------------------------------------------------------------- 5 SOLE VOTING POWER 0 shares. ----------------------------------------------------------------- 6 SHARED VOTING POWER 5,065,930 shares, of which 4,863,016 are directly owned by NUMBER OF PVP III, 126,266 are directly owned by Entrepreneurs' III and SHARES 76,648 are directly owned by Founders' III. Polaris III is BENEFICIALLY the general partner of PVP III, Entrepreneurs' III and OWNED BY Founders' III. Arnold is a managing member of Polaris III, EACH and may be deemed to have shared power to vote these shares. REPORTING ----------------------------------------------------------------- PERSON 7 SOLE DISPOSITIVE POWER WITH 0 shares. ----------------------------------------------------------------- 8 SHARED DISPOSITIVE POWER 5,065,930 shares, of which 4,863,016 are directly owned by PVP III, 126,266 are directly owned by Entrepreneurs' III and 76,648 are directly owned by Founders' III. Polaris III is the general partner of PVP III, Entrepreneurs' III and Founders' III. Arnold is a managing member of Polaris III, and may be deemed to have shared power to dispose of these shares. - -------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 5,065,930 - -------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* [ ] - -------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 20.6% 19.9% - -------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* IN IN - -------------------------------------------------------------------------------- CUSIP NO. 60877T101 13 G Page 9 of 18 - -------------------------------------------------------------------------------- 1 NAME OF REPORTING SS OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON Alan G. Spoon ("Spoon") Tax ID Number: - -------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [ ] (b) [X] - -------------------------------------------------------------------------------- 3 SEC USE ONLY - -------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION U.S. Citizen - -------------------------------------------------------------------------------- 5 SOLE VOTING POWER 0 shares. ----------------------------------------------------------------- 6 SHARED VOTING POWER 5,065,930 shares, of which 4,863,016 are directly owned by PVP III, 126,266 are directly owned by Entrepreneurs' III and NUMBER OF 76,648 are directly owned by Founders' III. Polaris III is SHARES the general partner of PVP III, Entrepreneurs' III and BENEFICIALLY Founders' III. spoon is a managing member of Polaris III, OWNED BY and may be deemed to have shared power to vote these shares. EACH ----------------------------------------------------------------- REPORTING 7 SOLE DISPOSITIVE POWER PERSON WITH 0 shares. ----------------------------------------------------------------- 8 SHARED DISPOSITIVE POWER 5,065,930 shares, of which 4,863,016 are directly owned by PVP III, 126,266 are directly owned by Entrepreneurs' III and 76,648 are directly owned by Founders' III. Polaris III is the general partner of PVP III, Entrepreneurs' III and Founders' III. Spoon is a managing member of Polaris III, and may be deemed to have shared power to dispose of these shares. - -------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 5,065,930 - -------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* [ ] - -------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 20.6% 19.9% - -------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* IN IN - -------------------------------------------------------------------------------- CUSIP NO. 60877T101 13 G Page 10 of 18 ITEM 1(A). NAME OF ISSUER Momenta Pharmaceuticals, Inc. ITEM 1(B). ADDRESS OF ISSUER'S PRINCIPAL EXECUTIVE OFFICES 43 Moulton Street Cambridge, Massachusetts 02138 ITEM 2(A). NAME OF PERSONS FILING This Statement is filed by Polaris Venture Partners III, L.P., a Delaware limited partnership ("PVP III"), Polaris Venture Partners Entrepreneurs' Fund III, L.P., a Delaware limited partnership ("Entrepreneurs' III"), Polaris Venture Partners Founders' Fund III, L.P., a Delaware limited partnership ("Founders' III"), Polaris Venture Management Co. III, L.L.C., a Delaware limited liability company ("Polaris III"), Jonathan A. Flint ("Flint"), Terrance G. McGuire ("McGuire"), Stephen D. Arnold ("Arnold") and Alan G. Spoon ("Spoon"). Flint, McGuire, Arnold and Spoon are the managing members of Polaris III. The foregoing entities and individuals are collectively referred to as the "Reporting Persons." Polaris III, the general partner of PVP III, Entrepreneurs' III and Founders' III, may be deemed to have sole power to vote and sole power to dispose of shares of the issuer directly owned by PVP III, Entrepreneurs' III and Founders' III. Flint, McGuire, Arnold and Spoon are the managing members of Polaris III and may be deemed to have shared power to vote and shared power to dispose of shares of the issuer directly owned by PVP III, Entrepreneurs' III and Founders' III. ITEM 2(B). ADDRESS OF PRINCIPAL OFFICE The address for each of the Reporting Persons is: Polaris Venture Partners 1000 Winter Street, Suite 3350 Waltham, Massachusetts 02451 ITEM 2(C) CITIZENSHIP PVP III, Entrepreneurs' III and Founders' III are Delaware limited partnerships; Polaris III is a Delaware Limited Liability Company; Flint, McGuire, Arnold and Spoon are United States citizens. ITEM 2(D) AND (E). TITLE OF CLASS OF SECURITIES AND CUSIP NUMBER Common Stock CUSIP # 60877T101 ITEM 3. Not Applicable ITEM 4. OWNERSHIP The following information with respect to the ownership of the Common Stock of the issuer by the persons filing this Statement is provided as of December 31, 2004: CUSIP NO. 60877T101 13 G Page 11 of 18 (a) Amount beneficially owned: See Row 9 of cover page for each Reporting Person. (b) Percent of Class: See Row 11 of cover page for each Reporting Person. (c) Number of shares as to which such person has: (i) Sole power to vote or to direct the vote: See Row 5 of cover page for each Reporting Person. (ii) Shared power to vote or to direct the vote: See Row 6 of cover page for each Reporting Person. (iii) Sole power to dispose or to direct the disposition of: See Row 7 of cover page for each Reporting Person. (iv) Shared power to dispose or to direct the disposition of: See Row 8 of cover page for each Reporting Person. ITEM 5. OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS. Not applicable. ITEM 6. OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER PERSON. Under certain circumstances set forth in the limited partnership agreements of PVP III, Entrepreneurs' III and Founders' III, the general and limited partners of each of such entities may be deemed to have the right to receive dividends from, or the proceeds from, the sale of shares of the issuer owned by each such entity of which they are a partner. 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. CUSIP NO. 60877T101 13 G Page 12 of 18 ITEM 10. CERTIFICATION. Not applicable. Page 13 of 18 SIGNATURES 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. Dated: February 11, 2005 POLARIS VENTURE PARTNERS III, L.P., /s/ Kevin Littlejohn a Delaware Limited Partnership ---------------------------------------- Signature Kevin Littlejohn Authorized Signatory POLARIS VENTURE PARTNERS /s/ Kevin Littlejohn ENTREPRENEURS' FUND III, L.P., ---------------------------------------- a Delaware Limited Partnership Signature Kevin Littlejohn Authorized Signatory POLARIS VENTURE PARTNERS /s/ Kevin Littlejohn FOUNDERS' FUND III, L.P., ---------------------------------------- a Delaware Limited Partnership Signature Kevin Littlejohn Authorized Signatory POLARIS VENTURE /s/ Kevin Littlejohn MANAGEMENT CO. III, L.L.C., ---------------------------------------- a Delaware Limited Liability Company Signature Kevin Littlejohn Authorized Signatory JONATHAN A. FLINT /s/ Kevin Littlejohn ---------------------------------------- Signature Kevin Littlejohn Authorized Signatory Page 14 of 18 TERRANCE G. MCGUIRE /s/ Kevin Littlejohn ---------------------------------------- Signature Kevin Littlejohn Authorized Signatory STEPHEN D. ARNOLD /s/ Kevin Littlejohn ---------------------------------------- Signature Kevin Littlejohn Authorized Signatory ALAN G. SPOON /s/ Kevin Littlejohn ---------------------------------------- Signature Kevin Littlejohn Authorized Signatory Page 15 of 18 EXHIBIT INDEX
Found on Sequentially Exhibit Numbered Page - ------- ------------- Exhibit A: Agreement of Joint Filing 16 Exhibit B: Reference to Kevin Littlejohn as Authorized Signatory 18
Page 16 of 18 EXHIBIT A Agreement of Joint Filing The undersigned hereby agree that a single Schedule 13G (or any amendment thereto) relating to the Common Stock of Momenta Pharmaceuticals, Inc. shall be filed on behalf of each of the undersigned and that this Agreement shall be filed as an exhibit to such Schedule 13G. Dated: February 11, 2005 POLARIS VENTURE PARTNERS III, L.P., /s/ Kevin Littlejohn a Delaware Limited Partnership ---------------------------------------- Signature Kevin Littlejohn Authorized Signatory POLARIS VENTURE PARTNERS /s/ Kevin Littlejohn ENTREPRENEURS' FUND III, L.P., ---------------------------------------- a Delaware Limited Partnership Signature Kevin Littlejohn Authorized Signatory POLARIS VENTURE PARTNERS /s/ Kevin Littlejohn FOUNDERS' FUND III, L.P., ---------------------------------------- a Delaware Limited Partnership Signature Kevin Littlejohn Authorized Signatory POLARIS VENTURE /s/ Kevin Littlejohn MANAGEMENT CO. III, L.L.C., ---------------------------------------- a Delaware Limited Liability Company Signature Kevin Littlejohn Authorized Signatory JONATHAN A. FLINT /s/ Kevin Littlejohn ---------------------------------------- Signature Kevin Littlejohn Authorized Signatory Page 17 of 18 TERRANCE G. MCGUIRE /s/ Kevin Littlejohn ---------------------------------------- Signature Kevin Littlejohn Authorized Signatory STEPHEN D. ARNOLD /s/ Kevin Littlejohn ---------------------------------------- Signature Kevin Littlejohn Authorized Signatory ALAN G. SPOON /s/ Kevin Littlejohn ---------------------------------------- Signature Kevin Littlejohn Authorized Signatory Page 18 of 18 EXHIBIT B REFERENCE TO KEVIN LITTLEJOHN AS AUTHORIZED SIGNATORY Kevin Littlejohn has signed the enclosed documents as Authorized Signatory. Note that copies of the applicable Agreement to File Jointly and Statement Appointing Designated Filer And Authorized Signatory are already on file with the appropriate agencies. -----END PRIVACY-ENHANCED MESSAGE-----