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