0001104659-14-012354.txt : 20140221
0001104659-14-012354.hdr.sgml : 20140221
20140221174644
ACCESSION NUMBER: 0001104659-14-012354
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20140220
FILED AS OF DATE: 20140221
DATE AS OF CHANGE: 20140221
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: CONCERT PHARMACEUTICALS, INC.
CENTRAL INDEX KEY: 0001367920
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 000000000
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 99 HAYDEN AVENUE
STREET 2: SUITE 500
CITY: LEXINGTON
STATE: MA
ZIP: 02421
BUSINESS PHONE: 781-860-0045
MAIL ADDRESS:
STREET 1: 99 HAYDEN AVENUE
STREET 2: SUITE 500
CITY: LEXINGTON
STATE: MA
ZIP: 02421
FORMER COMPANY:
FORMER CONFORMED NAME: CONCERT PHARMACEUTICALS INC
DATE OF NAME CHANGE: 20060628
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Freund John Gordon
CENTRAL INDEX KEY: 0001296771
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36310
FILM NUMBER: 14634921
MAIL ADDRESS:
STREET 1: 125 UNIVERSITY AVE.
STREET 2: C/O SKYLINE VENTURES
CITY: PALO ALTO
STATE: CA
ZIP: 94301
4
1
a4.xml
4
X0306
4
2014-02-20
0
0001367920
CONCERT PHARMACEUTICALS, INC.
CNCE
0001296771
Freund John Gordon
525 UNIVERSITY AVENUE
PALO ALTO
CA
94301
1
0
1
0
Common Stock
2014-02-20
4
C
0
389380
A
421752
I
See Footnote
Common Stock
2014-02-20
4
C
0
530974
A
952726
I
See Footnote
Common Stock
2014-02-20
4
C
0
106194
A
1058920
I
See Footnote
Common Stock
2014-02-20
4
P
0
150000
14.00
A
1208920
I
See Footnote
Series A Convertible Preferred Stock
2014-02-20
4
C
0
2200000
0
D
Common Stock
389380
0
I
See Footnote
Series B Convertible Preferred Stock
2014-02-20
4
C
0
3000000
0
D
Common Stock
530974
0
I
See Footnote
Series C Convertible Preferred Stock
2014-02-20
4
C
0
600000
0
D
Common Stock
106194
0
I
See Footnote
The Series A, Series B and Series C Convertible Preferred Stock converted into Common Stock on a 1-for-5.65 basis upon the closing of the issuer's initial public offering without payment of consideration.
Held by Skyline Venture Partners Qualified Purchaser Fund IV L.P. Dr. John G. Freund is a Managing Member of Skyline Venture Management IV, LLC, which is the sole general partner of Skyline Venture Partners Qualified Purchaser Fund IV, L.P., and as such may be deemed to share voting and dispositive power with respect to all shares held by Skyline Venture Partners Qualified Purchaser Fund IV, L.P. Dr. Freund disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein.
Not applicable.
JOHN G. FREUND, M.D. Kerensa Kenny, Attorney-in-Fact
2014-02-21