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