0001012975-15-000400.txt : 20150515 0001012975-15-000400.hdr.sgml : 20150515 20150515140711 ACCESSION NUMBER: 0001012975-15-000400 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150514 FILED AS OF DATE: 20150515 DATE AS OF CHANGE: 20150515 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Foundation Medicine, Inc. CENTRAL INDEX KEY: 0001488613 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MEDICAL LABORATORIES [8071] IRS NUMBER: 271316416 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 150 SECOND STREET CITY: CAMBRIDGE STATE: MA ZIP: 02141 BUSINESS PHONE: 617-418-2200 MAIL ADDRESS: STREET 1: 150 SECOND STREET CITY: CAMBRIDGE STATE: MA ZIP: 02141 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Third Rock Ventures GP, L.P. CENTRAL INDEX KEY: 0001578976 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36086 FILM NUMBER: 15867805 BUSINESS ADDRESS: STREET 1: C/O THIRD ROCK VENTURES STREET 2: 29 NEWBURY STREET, 3RD FLOOR CITY: BOSTON STATE: MA ZIP: 02116 BUSINESS PHONE: 617-585-2000 MAIL ADDRESS: STREET 1: C/O THIRD ROCK VENTURES STREET 2: 29 NEWBURY STREET, 3RD FLOOR CITY: BOSTON STATE: MA ZIP: 02116 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: THIRD ROCK VENTURES LP CENTRAL INDEX KEY: 0001408591 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36086 FILM NUMBER: 15867806 BUSINESS ADDRESS: STREET 1: 29 NEWBURY STREET STREET 2: SUITE 401 CITY: BOSTON STATE: MA ZIP: 02116 BUSINESS PHONE: 617-859-3099 MAIL ADDRESS: STREET 1: 29 NEWBURY STREET STREET 2: SUITE 401 CITY: BOSTON STATE: MA ZIP: 02116 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: TEPPER ROBERT I CENTRAL INDEX KEY: 0001192595 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36086 FILM NUMBER: 15867807 MAIL ADDRESS: STREET 1: 40 LANDSDOWNE STREET CITY: CAMBRIDGE STATE: MA ZIP: 02139 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: STARR KEVIN P CENTRAL INDEX KEY: 0001192603 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36086 FILM NUMBER: 15867808 MAIL ADDRESS: STREET 1: 75 SIDNEY STREET CITY: CAMBRIDGE STATE: MA ZIP: 02139 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LEVIN MARK J CENTRAL INDEX KEY: 0001180428 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36086 FILM NUMBER: 15867809 MAIL ADDRESS: STREET 1: 40 LANDSDOWNE STREET CITY: CAMBRIDGE STATE: MA ZIP: 02139 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: TRV GP, LLC CENTRAL INDEX KEY: 0001578973 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36086 FILM NUMBER: 15867810 BUSINESS ADDRESS: STREET 1: C/O THIRD ROCK VENTURES STREET 2: 29 NEWBURY STREET, 3RD FLOOR CITY: BOSTON STATE: MA ZIP: 02116 BUSINESS PHONE: 617-585-2000 MAIL ADDRESS: STREET 1: C/O THIRD ROCK VENTURES STREET 2: 29 NEWBURY STREET, 3RD FLOOR CITY: BOSTON STATE: MA ZIP: 02116 4 1 edgar.xml PRIMARY DOCUMENT X0306 4 2015-05-14 1 0001488613 Foundation Medicine, Inc. FMI 0001408591 THIRD ROCK VENTURES LP 29 NEWBURY STREET, 3RD FLOOR BOSTON MA 02116 0 0 1 0 0001578976 Third Rock Ventures GP, L.P. 29 NEWBURY STREET, 3RD FLOOR BOSTON MA 02116 0 0 1 0 0001578973 TRV GP, LLC 29 NEWBURY STREET, 3RD FLOOR BOSTON MA 02116 0 0 1 0 0001180428 LEVIN MARK J 29 NEWBURY STREET, 3RD FLOOR BOSTON MA 02116 0 0 1 0 0001192603 STARR KEVIN P 29 NEWBURY STREET, 3RD FLOOR BOSTON MA 02116 0 0 1 0 0001192595 TEPPER ROBERT I 29 NEWBURY STREET, 3RD FLOOR BOSTON MA 02116 0 0 1 0 Common Stock 2015-05-14 4 J 0 828456 0 D 0 D Common Stock 2015-05-14 4 J 0 312498 0 A 312498 D Common Stock 2015-05-14 4 J 0 312498 0 D 0 D Distribution of shares in kind by Third Rock Ventures, L.P. ("TRV") to its partners. The shares are directly held by TRV. The general partner of TRV is Third Rock Ventures GP, L.P. ("TRV GP"). The general partner of TRV GP is TRV GP, LLC ("TRV GP LLC"). The individual managers of TRV GP LLC are Mark Levin ("Levin"), Kevin Starr ("Starr") and Dr. Robert Tepper ("Tepper") and, as such, each of TRV GP and TRV GP LLC, Levin, Starr and Tepper exercises shared voting and investment power over the shares held of record by TRV. Each of the Reporting Persons disclaims beneficial ownership of the shares except to the extent of their pecuniary interest therein, if any TRV GP received shares distributed in kind by TRV to its partners The shares are directly held by TRV GP. As such, each of TRV GP LLC, Levin, Starr and Tepper exercises voting and investment power over the shares of record by TRV GP. Distribution of shares in kind by TRV GP to its partners. /s/ Kevin Gillis, Chief Financial Officer of TRV GP, LLC, general partner of Third Rock Ventures GP, L.P., general partner of Third Rock Ventures, L.P. 2015-05-14 /s/ Kevin Gillis, Chief Financial Officer of TRV GP, LLC, general partner of Third Rock Ventures GP, L.P. 2015-05-14 /s/ Kevin Gillis, Chief Financial Officer of TRV GP, LLC 2015-05-14 /s/ Kevin Gillis by power of attorney for Mark Levin 2015-05-14 /s/ Kevin Gillis by power of attorney for Kevin Starr 2015-05-14 /s/ Kevin Gillis by power of attorney for Robert I. Tepper 2015-05-14