0000903423-14-000118.txt : 20140220 0000903423-14-000118.hdr.sgml : 20140220 20140220185653 ACCESSION NUMBER: 0000903423-14-000118 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20140219 FILED AS OF DATE: 20140220 DATE AS OF CHANGE: 20140220 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CONCERT PHARMACEUTICALS, INC. CENTRAL INDEX KEY: 0001367920 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 000000000 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 99 HAYDEN AVENUE STREET 2: SUITE 500 CITY: LEXINGTON STATE: MA ZIP: 02421 BUSINESS PHONE: 781-860-0045 MAIL ADDRESS: STREET 1: 99 HAYDEN AVENUE STREET 2: SUITE 500 CITY: LEXINGTON STATE: MA ZIP: 02421 FORMER COMPANY: FORMER CONFORMED NAME: CONCERT PHARMACEUTICALS INC DATE OF NAME CHANGE: 20060628 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: GLAXOSMITHKLINE PLC CENTRAL INDEX KEY: 0001131399 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36310 FILM NUMBER: 14631185 BUSINESS ADDRESS: STREET 1: 980 GREAT WEST ROAD CITY: BRENTFORD MIDDLESEX STATE: X0 ZIP: TW8 9GS BUSINESS PHONE: 011442080475000 MAIL ADDRESS: STREET 1: 980 GREAT WEST ROAD CITY: BRENTFORD MIDDLESEX STATE: X0 ZIP: TW8 9GS 4 1 glaxo-concert.xml OWNERSHIP DOCUMENT X0306 4 2014-02-19 1 0001367920 CONCERT PHARMACEUTICALS, INC. CNCE 0001131399 GLAXOSMITHKLINE PLC 980 GREAT WEST ROAD BRENTFORD MIDDLESEX, X0 TW 89GS UNITED KINGDOM 0 0 0 1 Former 10% Owner Common Stock 2014-02-19 4 C 0 141592 A 141592 I By S.R. One Limited Common Stock 2014-02-19 4 C 0 1179941 A 1321533 I By Glaxo Group Limited Common Stock 2014-02-19 4 P 0 35000 14.00 A 1356533 I By S.R. One Limited Series C Convertible Preferred Stock 2014-02-19 4 C 0 800000 0 D Common Stock 141592 0 I By S.R. One Limited Series D Convertible Preferred Stock 2014-02-19 4 C 0 6666667 0 D Common Stock 1179941 0 I By Glaxo Group Limited The Series C Convertible Preferred Stock and Series D Convertible Preferred Stock of Concert Pharmaceuticals, Inc. (the "Issuer") automatically converted into Common Stock of the Issuer on a 1-for-5.65 basis upon the closing of the Issuer's initial public offering on February 19, 2014 without payment of consideration. Shares are held by S.R. One, Limited, an indirect, wholly-owned subsidiary of GlaxoSmithKline plc (the "Reporting Person"). Shares are held by Glaxo Group Limited, an indirect, wholly-owned subsidiary of the Reporting Person. Not applicable. /s/ Simon Dingemans, Chief Financial Officer 2014-02-20