0000899243-21-009153.txt : 20210302 0000899243-21-009153.hdr.sgml : 20210302 20210302202833 ACCESSION NUMBER: 0000899243-21-009153 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210226 FILED AS OF DATE: 20210302 DATE AS OF CHANGE: 20210302 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Shegog Todd CENTRAL INDEX KEY: 0001714564 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39333 FILM NUMBER: 21706583 MAIL ADDRESS: STREET 1: 200 SIDNEY STREET, SUITE 320 STREET 2: C/O SYNLOGIC, INC. CITY: CAMBRIDGE STATE: MA ZIP: 02139 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Forma Therapeutics Holdings, Inc. CENTRAL INDEX KEY: 0001538927 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 371657129 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 500 ARSENAL STREET STREET 2: SUITE 100 CITY: WATERTOWN STATE: MA ZIP: 02472 BUSINESS PHONE: 617-679-1970 MAIL ADDRESS: STREET 1: 500 ARSENAL STREET STREET 2: SUITE 100 CITY: WATERTOWN STATE: MA ZIP: 02472 FORMER COMPANY: FORMER CONFORMED NAME: Forma Therapeutics Holdings, Inc., DATE OF NAME CHANGE: 20200331 FORMER COMPANY: FORMER CONFORMED NAME: Forma Therapeutics Holdings LLC DATE OF NAME CHANGE: 20120106 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-02-26 1 0001538927 Forma Therapeutics Holdings, Inc. FMTX 0001714564 Shegog Todd C/O FORMA THERAPEUTICS HOLDINGS, INC. 500 ARSENAL STREET, SUITE 100 WATERTOWN MA 02472 0 1 0 0 SVP, Chief Financial Officer Common Stock 2021-02-26 4 A 0 16500 0.00 A 16500 D Common Stock 2021-02-26 4 A 0 12000 0.00 A 28500 D Stock Option (Right to Buy) 38.61 2021-02-26 4 A 0 50250 0.00 A 2031-02-25 Common Stock 50250 0 D These shares represented restricted stock units and will be settled into common stock upon vesting. Each restricted stock unit would be converted into one share of FMTX common stock. 25% of the shares subject to the stock option shall vest on February 22, 2022, and the remainder of the shares vest in equal monthly installments for a period of 36 months thereafter. /s/ Jeannette Potts, as Attorney-in-Fact 2021-03-02