0001181431-12-004233.txt : 20120127 0001181431-12-004233.hdr.sgml : 20120127 20120127172340 ACCESSION NUMBER: 0001181431-12-004233 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120126 FILED AS OF DATE: 20120127 DATE AS OF CHANGE: 20120127 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Verastem, Inc. CENTRAL INDEX KEY: 0001526119 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 273269467 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 215 FIRST STREET STREET 2: SUITE 440 CITY: CAMBRIDGE STATE: MA ZIP: 02142 BUSINESS PHONE: 617-252-9300 MAIL ADDRESS: STREET 1: 215 FIRST STREET STREET 2: SUITE 440 CITY: CAMBRIDGE STATE: MA ZIP: 02142 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CHP III LP CENTRAL INDEX KEY: 0001384619 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35403 FILM NUMBER: 12552783 BUSINESS ADDRESS: STREET 1: C/O CARDINAL HEALTH PARTNERS STREET 2: 230 NASSAU STREET CITY: PRINCETON STATE: NJ ZIP: 08542 BUSINESS PHONE: 6099246452 MAIL ADDRESS: STREET 1: C/O CARDINAL HEALTH PARTNERS STREET 2: 230 NASSAU STREET CITY: PRINCETON STATE: NJ ZIP: 08542 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CHP III Management, L.L.C. CENTRAL INDEX KEY: 0001540704 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35403 FILM NUMBER: 12552784 BUSINESS ADDRESS: STREET 1: C/O CARDINAL PARTNERS STREET 2: 230 NASSAU STREET CITY: PRINCETON STATE: NJ ZIP: 08542 BUSINESS PHONE: 609-924-6452 MAIL ADDRESS: STREET 1: C/O CARDINAL PARTNERS STREET 2: 230 NASSAU STREET CITY: PRINCETON STATE: NJ ZIP: 08542 3 1 rrd331745.xml FORM 3 X0204 3 2012-01-26 0 0001526119 Verastem, Inc. VSTM 0001384619 CHP III LP C/O CARDINAL PARTNERS 230 NASSAU STREET PRINCETON NJ 08542 0 0 1 0 0001540704 CHP III Management, L.L.C. C/O CARDINAL PARTNERS 230 NASSAU STREET PRINCETON NJ 08542 0 0 1 0 Series A Preferred Stock Common Stock 1142857 D Series B Preferred Stock Common Stock 714285 D Series C Preferred Stock Common Stock 126984 D Each share of preferred stock will automatically convert into approximately 0.29 shares of common stock upon the closing of the issuer's initial public offering. The shares have no expiration date. CHP III Management, L.L.C. is the sole General Partner of CHP III, L.P. John K. Clarke, Brandon H. Hull, Charles G. Hadley and John J. Park. (collectively, the "Managing Members") are Managing Members of CHP III Management, L.L.C., and, as such, may be deemed to have shared voting and dispositive power with respect to the issuer's securities held of CHP III, L.P. (the "CHP III Shares"). Each of the Managing Members disclaim beneficial ownership of the CHP III Shares, except to the extent of their respective pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of the shares for purposes of Section 16 or for any other purpose. /s/ John J. Park, Managing Member of CHP III Management, L.L.C., the General Partner of CHP III, L.P. 2012-01-27