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