0000903423-19-000302.txt : 20190717
0000903423-19-000302.hdr.sgml : 20190717
20190717193705
ACCESSION NUMBER: 0000903423-19-000302
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190717
FILED AS OF DATE: 20190717
DATE AS OF CHANGE: 20190717
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: GLAXOSMITHKLINE PLC
CENTRAL INDEX KEY: 0001131399
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
STATE OF INCORPORATION: X0
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38978
FILM NUMBER: 19960175
BUSINESS ADDRESS:
STREET 1: 980 GREAT WEST ROAD
CITY: BRENTFORD MIDDLESEX
STATE: X0
ZIP: TW8 9GS
BUSINESS PHONE: 011442080475000
MAIL ADDRESS:
STREET 1: 980 GREAT WEST ROAD
CITY: BRENTFORD MIDDLESEX
STATE: X0
ZIP: TW8 9GS
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Fulcrum Therapeutics, Inc.
CENTRAL INDEX KEY: 0001680581
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 474839948
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 26 LANDSDOWNE STREET
CITY: CAMBRIDGE
STATE: MA
ZIP: 02139
BUSINESS PHONE: 617-651-8851
MAIL ADDRESS:
STREET 1: 26 LANDSDOWNE STREET
CITY: CAMBRIDGE
STATE: MA
ZIP: 02139
3
1
fulcrum.xml
OWNERSHIP DOCUMENT
X0206
3
2019-07-17
0
0001680581
Fulcrum Therapeutics, Inc.
FULC
0001131399
GLAXOSMITHKLINE PLC
980 GREAT WEST ROAD
BRENTFORD MIDDLESEX
X0
TW8 9GS
UNITED KINGDOM
0
0
1
0
Series B Preferred Stock
Common Stock
1785714
I
See footnote
The Series B Preferred Stock is convertible on a seven-for-one basis into the number of shares of Common Stock as shown in Column 3 at any time at the holder's election, and automatically upon the closing of the Issuer's initial public offering without payment of further consideration. The shares have no expiration date.
The shares reported herein are held of record by Glaxo Group Limited, an indirect, wholly-owned subsidiary of GlaxoSmithKline plc (the "Reporting Person").
/s/ Victoria Whyte
2019-07-17