0001209191-14-012941.txt : 20140221 0001209191-14-012941.hdr.sgml : 20140221 20140221140236 ACCESSION NUMBER: 0001209191-14-012941 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20140219 FILED AS OF DATE: 20140221 DATE AS OF CHANGE: 20140221 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: QVT Fund V LP CENTRAL INDEX KEY: 0001543904 STATE OF INCORPORATION: E9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36310 FILM NUMBER: 14632898 BUSINESS ADDRESS: STREET 1: 87 MARY STREET STREET 2: GEORGE TOWN CITY: GRAND CAYMAN STATE: E9 ZIP: KY1-9005 BUSINESS PHONE: 2127056229 MAIL ADDRESS: STREET 1: 1177 AVENUE OF THE AMERICAS STREET 2: 9TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10036 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: QVT Associates GP LLC CENTRAL INDEX KEY: 0001290166 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36310 FILM NUMBER: 14632899 BUSINESS ADDRESS: STREET 1: 1177 AVENUE OF THE AMERICAS STREET 2: 9TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10036 BUSINESS PHONE: 212-705-8800 MAIL ADDRESS: STREET 1: 1177 AVENUE OF THE AMERICAS STREET 2: 9TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10036 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2014-02-19 1 0001367920 CONCERT PHARMACEUTICALS, INC. CNCE 0001290166 QVT Associates GP LLC 1177 AVENUE OF THE AMERICAS, 9TH FLOOR NEW YORK NY 10036 0 0 1 0 0001543904 QVT Fund V LP 1177 AVENUE OF THE AMERICAS, 9TH FLOOR NEW YORK NY 10036 0 0 1 0 Common Stock, $0.001 par value 2014-02-19 4 C 0 259999 A 259999 I Through QVT Fund IV LP, QVT Fund V LP and Quintessence Fund L.P. Common Stock, $0.001 par value 2014-02-19 4 P 0 300000 14.00 A 559999 I Through QVT Fund IV LP, QVT Fund V LP and Quintessence Fund L.P. Series A Convertible Preferred Stock 2014-02-19 4 C 0 250000 0.00 D Common Stock 44247 0 I Through QVT Fund IV LP, QVT Fund V LP and Quintessence Fund L.P. Series B Convertible Preferred Stock 2014-02-19 4 C 0 1000000 0.00 D Common Stock 176991 0 I Through QVT Fund IV LP, QVT Fund V LP and Quintessence Fund L.P. Series C Convertible Preferred Stock 2014-02-19 4 C 0 219000 0.00 D Common Stock 38761 0 I Through QVT Fund IV LP, QVT Fund V LP and Quintessence Fund L.P. 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. QVT Associates GP LLC is the general partner of QVT Fund IV LP, QVT Fund V LP and Quintessence Fund L.P. (together with QVT Fund IV LP, and QVT Fund V LP, the "Funds"). QVT Financial LP is the investment manager for the Funds and therefore may be deemed the beneficial owner of the Common Stock held by the Funds. QVT Financial GP LLC is the general partner of QVT Financial LP and therefore may be deemed the beneficial owner of Common Stock beneficially owned by QVT Financial LP. The reporting person disclaims beneficial ownership of the reported securities except to the extent of its pecuniary interest therein. Not applicable. These 300,000 shares were purchased by the Funds in the Issuer's initial public offering, at which time the reporting persons were no longer 10% owners or otherwise subject to Section 16. /s/ Tracy Fu, Managing Member 2014-02-21