0001209191-20-038965.txt : 20200625 0001209191-20-038965.hdr.sgml : 20200625 20200625174849 ACCESSION NUMBER: 0001209191-20-038965 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200623 FILED AS OF DATE: 20200625 DATE AS OF CHANGE: 20200625 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Wellington Biomedical Innovation Master Investors (Cayman) I L.P. CENTRAL INDEX KEY: 0001787092 STATE OF INCORPORATION: E9 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39333 FILM NUMBER: 20990318 BUSINESS ADDRESS: STREET 1: WELLINGTON ALTERNATIVE INVESTMENTS LLC STREET 2: 280 CONGRESS STREET CITY: BOSTON STATE: MA ZIP: 02210 BUSINESS PHONE: (617) 951-5372 MAIL ADDRESS: STREET 1: WELLINGTON ALTERNATIVE INVESTMENTS LLC STREET 2: 280 CONGRESS STREET CITY: BOSTON STATE: MA ZIP: 02210 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 LLC DATE OF NAME CHANGE: 20120106 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2020-06-23 1 0001538927 Forma Therapeutics Holdings, Inc., FMTX 0001787092 Wellington Biomedical Innovation Master Investors (Cayman) I L.P. WELLINGTON ALTERNATIVE INVESTMENTS LLC 280 CONGRESS STREET BOSTON MA 02210 0 0 1 0 Common Stock 2020-06-23 4 C 0 1252913 A 1252913 D Common Stock 2020-06-23 4 P 0 1000000 20.00 A 2252913 D Series D Convertible Preferred Stock 2020-06-23 4 C 0 5359344 D Common Stock 1252913 0 D On June 23, 2020, the Series D Convertible Preferred Stock automatically converted into common stock on a 4.2775-for-one basis without payment of further consideration upon the closing of the initial public offering of the Issuer's common stock. The shares had no expiration date. /s/ Wellington Biomedical Innovation Master Investors (Cayman) I L.P., By: Wellington Management Company LLP, as investment advisor, /s/ Peter N. McIsaac, Title: Authorized Person 2020-06-25