SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
TVM Life Science Ventures VI GmbH & Co KG

(Last) (First) (Middle)
C/O TVM CAPITAL GROUP
OTTOSTRASSE 4

(Street)
MUNICH 2M 80333

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
CONCERT PHARMACEUTICALS, INC. [ CNCE ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
02/19/2014
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 02/19/2014 C 289,991 A (1) 329,535(2) D(2)
Common Stock 02/19/2014 C 560,211 A (1) 889,746(2) D(2)
Common Stock 02/19/2014 C 148,936 A (1) 1,038,682(2) D(2)
Common Stock 02/19/2014 C 99,389 A (1) 112,942(3) I By TVM Life Sciences Ventures VI LP(3)
Common Stock 02/19/2014 C 192,003 A (1) 304,945(3) I By TVM Life Sciences Ventures VI LP(3)
Common Stock 02/19/2014 C 51,045 A (1) 355,990(3) I By TVM Life Sciences Ventures VI LP(3)
Common Stock 02/19/2014 P 66,287 A $14 1,104,969(2) D(2)
Common Stock 02/19/2014 P 22,713 A $14 378,703(3) I By TVM Life Sciences Ventures VI LP(3)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Series A Convertible Preferred Stock (1) 02/19/2014 C 1,638,450 (1) (4) Common Stock 289,991 $0.00 0 D(2)
Series B Convertible Preferred Stock (1) 02/19/2014 C 3,165,187 (1) (4) Common Stock 560,211 $0.00 0 D(2)
Series C Convertible Preferred Stock (1) 02/19/2014 C 841,493 (1) (4) Common Stock 148,936 $0.00 0 D(2)
Series A Convertible Preferred Stock (1) 02/19/2014 C 561,550 (1) (4) Common Stock 99,389 $0.00 0 I By TVM Life Sciences Ventures VI LP(3)
Series B Convertible Preferred Stock (1) 02/19/2014 C 1,084,813 (1) (4) Common Stock 192,003 $0.00 0 I By TVM Life Sciences Ventures VI LP(3)
Series C Convertible Preferred Stock (1) 02/19/2014 C 288,407 (1) (4) Common Stock 51,045 $0.00 0 I By TVM Life Sciences Ventures VI LP(3)
1. Name and Address of Reporting Person*
TVM Life Science Ventures VI GmbH & Co KG

(Last) (First) (Middle)
C/O TVM CAPITAL GROUP
OTTOSTRASSE 4

(Street)
MUNICH 2M 80333

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
X Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Birner Hubert

(Last) (First) (Middle)
C/O TVM CAPITAL GROUP
OTTOSTRASSE 4

(Street)
MUNICH 2M 80333

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Fischer Stefan

(Last) (First) (Middle)
C/O TVM CAPITAL GROUP
OTTOSTRASSE 4

(Street)
MUNICH 2M 80333

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Goll Alexandra

(Last) (First) (Middle)
C/O TVM CAPITAL GROUP
OTTOSTRASSE 4

(Street)
MUNICH 2M 80333

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Polack Axel

(Last) (First) (Middle)
C/O TVM CAPITAL GROUP
OTTOSTRASSE 4

(Street)
MUNICH 2M 80333

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
SCHUHSLER HELMUT

(Last) (First) (Middle)
C/O TVM CAPITAL GROUP
OTTOSTRASSE 4

(Street)
MUNICH 2M 80333

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
X Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
TVM Life Science Ventures VI LP

(Last) (First) (Middle)
C/O TVM CAPITAL GROUP
OTTOSTRASSE 4

(Street)
MUNICH 2M 80333

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
1. The Series A, Series B and Series C Convertible Preferred Stock converted into Common Stock on a 1-for-5.65 basis upon the closing of the issuer's initial public offering without payment of consideration.
2. The shares are directly held by TVM Life Sciences Ventures VI GMBH & Co. KG ("TVM VI"). Alexandra Goll ("Goll"), Helmut Schuhsler ("Schuhsler"), Hubert Birner ("Birner"), Stefan Fischer ("Fischer") and Alex Polack ("Polack") are members of the investment committee of TVM Life Sciences Ventures VI Management VI Limited Partnership ("TVM VI Management"), a special limited partner of TVM VI, with voting and dispositive power over the shares held by TVM VI. TVM VI Management and these individuals each disclaim beneficial ownership of the shares held by TVM VI except to the extent of any pecuniary interest therein.
3. The shares are directly held by TVM Life Sciences Ventures VI LP ("TVM VI LP"). Goll, Schuhsler, Birner, Fischer and Polack are members of the investment committee of TVM VI Management, a special limited partner of TVM VI LP, with voting and dispositive power over the shares held by TVM VI LP. TVM VI Management and these individuals each disclaim beneficial ownership of the shares held by TVM VI LP except to the extent of any pecuniary interest therein.
4. Not applicable.
Remarks:
/s/ Stefan Fischer, Authorized Officer /s/ Josef Moosholzer, Authorized Officer 02/20/2014
/s/ Rolf Starck, Attorney-in-Fact for Hubert Birner 02/20/2014
/s/ Rolf Starck, Attorney-in-Fact for Stefan Fischer 02/20/2014
/s/ Rolf Starck, Attorney-in-Fact for Alexandra Goll 02/20/2014
/s/ Rolf Starck, Attorney-in-Fact for Axel Polack 02/20/2014
/s/ Rolf Starck, Attorney-in-Fact for Helmut Schuhsler 02/20/2014
/s/ Stefan Fischer, Director /s/ Josef Moosholzer, Officer 02/20/2014
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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