0001209191-14-011640.txt : 20140219
0001209191-14-011640.hdr.sgml : 20140219
20140219131033
ACCESSION NUMBER: 0001209191-14-011640
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20140219
FILED AS OF DATE: 20140219
DATE AS OF CHANGE: 20140219
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: CONCERT PHARMACEUTICALS, INC.
CENTRAL INDEX KEY: 0001367920
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 000000000
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: Tung Roger D
CENTRAL INDEX KEY: 0001594857
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36310
FILM NUMBER: 14624920
MAIL ADDRESS:
STREET 1: 99 HAYDEN AVENUE, SUITE 500
CITY: LEXINGTON
STATE: MA
ZIP: 02421
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2014-02-19
0
0001367920
CONCERT PHARMACEUTICALS, INC.
CNCE
0001594857
Tung Roger D
C/O CONCERT PHARMACEUTICALS, INC.
99 HAYDEN AVENUE, SUITE 500
LEXINGTON
MA
02421
1
1
1
0
Chief Executive Officer
Common Stock
2014-02-19
4
C
0
17699
A
401522
D
Common Stock
2014-02-19
4
C
0
8850
A
8850
I
By Tung Family Investment Trust
Common Stock
2014-02-19
4
C
0
4424
A
13274
I
By Tung Family Investment Trust
Common Stock
134761
I
By Roger D. Tung 2011 GRAT
Common Stock
12389
I
By RD Tung Irrevocable Trust
Series A Convertible Preferred Stock
2014-02-19
4
C
0
100000
0.00
D
Common Stock
17699
0
D
Series A Convertible Preferred Stock
2014-02-19
4
C
0
50000
0.00
D
Common Stock
8850
0
I
By Tung Family Investment Trust
Series B Convertible Preferred Stock
2014-02-19
4
C
0
25000
0.00
D
Common Stock
4424
0
I
By Tung Family Investment Trust
The Series A and Series B 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.
Shares held by the Tung Family Investment Trust. Dr. Tung is a co-trustee of the Tung Family Investment Trust. Dr. Tung disclaims beneficial ownership of such shares except to the extent of any pecuniary interest therein.
Shares held by Roger D. Tung 2011 GRAT. Dr. Tung is the sole trustee of the Roger D. Tung 2011 GRAT. Dr. Tung disclaims beneficial ownership of such shares except to the extent of any pecuniary interest therein.
Shares held by the RD Tung Irrevocable Trust. Dr. Tung's spouse is a co-trustee of the RD Tung Irrevocable Trust. Dr. Tung disclaims beneficial ownership of such shares except to the extent of any pecuniary interest therein.
Not applicable.
/s/ Roger D. Tung
2014-02-19