0000899243-22-021669.txt : 20220609 0000899243-22-021669.hdr.sgml : 20220609 20220609173715 ACCESSION NUMBER: 0000899243-22-021669 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220608 FILED AS OF DATE: 20220609 DATE AS OF CHANGE: 20220609 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Frederick Wayne A.I. CENTRAL INDEX KEY: 0001802241 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39333 FILM NUMBER: 221007034 MAIL ADDRESS: STREET 1: 500 W MAIN ST. CITY: LOUISVILLE STATE: KY ZIP: 40202 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: 300 NORTH BEACON STREET STREET 2: SUITE 501 CITY: WATERTOWN STATE: MA ZIP: 02472 BUSINESS PHONE: 617-679-1970 MAIL ADDRESS: STREET 1: 300 NORTH BEACON STREET STREET 2: SUITE 501 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 2022-06-08 0 0001538927 Forma Therapeutics Holdings, Inc. FMTX 0001802241 Frederick Wayne A.I. C/O FORMA THERAPEUTICS HOLDINGS, INC. 300 NORTH BEACON STREET, SUITE 501 WATERTOWN MA 02472 1 0 0 0 Common Stock 2022-06-08 4 A 0 4500 0.00 A 7250 D Stock Option (Right to Buy) 6.12 2022-06-08 4 A 0 6750 0.00 A 2032-06-07 Common Stock 6750 6750 D These shares represent 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. This option shall vest and become exercisable in full upon the earlier to occur of (i) June 8, 2023 and (ii) the next annual meeting of the Issuer's stockholders. /s/ Jeannette Potts, as Attorney-in-Fact 2022-06-09