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