0001104659-12-047930.txt : 20120706 0001104659-12-047930.hdr.sgml : 20120706 20120706172901 ACCESSION NUMBER: 0001104659-12-047930 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120703 FILED AS OF DATE: 20120706 DATE AS OF CHANGE: 20120706 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MOULDER LEON O JR CENTRAL INDEX KEY: 0001228865 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35587 FILM NUMBER: 12951388 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: TESARO, Inc. CENTRAL INDEX KEY: 0001491576 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 272249687 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1000 WINTER STREET, SUITE 3300 CITY: WALTHAM STATE: MA ZIP: 02451 BUSINESS PHONE: (339) 970-0900 MAIL ADDRESS: STREET 1: 1000 WINTER STREET, SUITE 3300 CITY: WALTHAM STATE: MA ZIP: 02451 FORMER COMPANY: FORMER CONFORMED NAME: Tesaro, Inc. DATE OF NAME CHANGE: 20100510 4 1 a4.xml 4 X0306 4 2012-07-03 0 0001491576 TESARO, Inc. TSRO 0001228865 MOULDER LEON O JR C/O TESARO, INC. 1000 WINTER STREET, SUITE 3300 WALTHAM MA 02451 1 1 0 0 Chief Executive Officer Common Stock 2012-07-03 4 C 0 428571 A 996428 D Series A Preferred Stock 2012-07-03 4 C 0 1500000 0 D Common Stock 428571 0 D The Series A Preferred Stock converted into shares of TESARO, Inc. common stock on a 3.5 for 1 basis immediately prior to the closing of the Issuer's initial public offering and had no expiration date. Reflects a 1-for-3.5 reverse stock split which became effective prior to the closing of the Issuer's initial public offering. /s/ Richard J. Rodgers, Attorney-in-Fact 2012-07-05