0000899243-21-009153.txt : 20210302
0000899243-21-009153.hdr.sgml : 20210302
20210302202833
ACCESSION NUMBER: 0000899243-21-009153
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210226
FILED AS OF DATE: 20210302
DATE AS OF CHANGE: 20210302
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Shegog Todd
CENTRAL INDEX KEY: 0001714564
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39333
FILM NUMBER: 21706583
MAIL ADDRESS:
STREET 1: 200 SIDNEY STREET, SUITE 320
STREET 2: C/O SYNLOGIC, INC.
CITY: CAMBRIDGE
STATE: MA
ZIP: 02139
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Forma Therapeutics Holdings, Inc.
CENTRAL INDEX KEY: 0001538927
STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836]
IRS NUMBER: 371657129
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 500 ARSENAL STREET
STREET 2: SUITE 100
CITY: WATERTOWN
STATE: MA
ZIP: 02472
BUSINESS PHONE: 617-679-1970
MAIL ADDRESS:
STREET 1: 500 ARSENAL STREET
STREET 2: SUITE 100
CITY: WATERTOWN
STATE: MA
ZIP: 02472
FORMER COMPANY:
FORMER CONFORMED NAME: Forma Therapeutics Holdings, Inc.,
DATE OF NAME CHANGE: 20200331
FORMER COMPANY:
FORMER CONFORMED NAME: Forma Therapeutics Holdings LLC
DATE OF NAME CHANGE: 20120106
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-02-26
1
0001538927
Forma Therapeutics Holdings, Inc.
FMTX
0001714564
Shegog Todd
C/O FORMA THERAPEUTICS HOLDINGS, INC.
500 ARSENAL STREET, SUITE 100
WATERTOWN
MA
02472
0
1
0
0
SVP, Chief Financial Officer
Common Stock
2021-02-26
4
A
0
16500
0.00
A
16500
D
Common Stock
2021-02-26
4
A
0
12000
0.00
A
28500
D
Stock Option (Right to Buy)
38.61
2021-02-26
4
A
0
50250
0.00
A
2031-02-25
Common Stock
50250
0
D
These shares represented restricted stock units and will be settled into common stock upon vesting. Each restricted stock unit would be converted into one share of FMTX common stock.
25% of the shares subject to the stock option shall vest on February 22, 2022, and the remainder of the shares vest in equal monthly installments for a period of 36 months thereafter.
/s/ Jeannette Potts, as Attorney-in-Fact
2021-03-02