Form D
View Original Filing
Notice of Exempt Offering of Securities
Item 1. Issuer's Identity
Name of Issuer:
FORMA THERAPEUTICS HOLDINGS LLC
Jurisdiction of Incorporation/Organization
DE
Year of Incorporation/Organization
2011
Entity Type
LIMITED LIABILITY COMPANY
Item 2 Issuer Principal Place of Business and Contact Information
500 ARSENAL STREET
SUITE 100
WATERTOWN, MA 02472
Phone Number:
subscription required
Item 3. Related Persons
Name
STEVEN TREGAY, PH.D.
Address
subscription required
Relationship(s)
- EXECUTIVE OFFICER
- DIRECTOR
Clarification of Response
Item 3. Related Persons
Name
ANDREW LITTLEHALE
Address
subscription required
Relationship(s)
Clarification of Response
Item 3. Related Persons
Name
PETER FINN
Address
subscription required
Relationship(s)
Clarification of Response
Item 3. Related Persons
Name
STEVEN HALL
Address
subscription required
Relationship(s)
Clarification of Response
Item 3. Related Persons
Name
REINHARD AMBROS, PH.D.
Address
subscription required
Relationship(s)
Clarification of Response
Item 3. Related Persons
Name
THONG-YUEN POON
Address
subscription required
Relationship(s)
Clarification of Response
Item 3. Related Persons
Name
MICHAEL A. FOLEY
Address
subscription required
Relationship(s)
Clarification of Response
Item 3. Related Persons
Name
ALEXIS BORISY
Address
subscription required
Relationship(s)
Clarification of Response
Item 4. Industry Group
OTHER
Item 5. Issuer Size
Revenue Range (for issuer not specifying "hedge" or "other investment" fund in Item 4 above)
DECLINE TO DISCLOSE
Item 6. Federal Exemptions and Exclusions Claimed
Item 7. Type of Filing
New Notice
Date of First Sale in this Offering:
08/29/2012
Item 8. Duration of Offering
Does the issuer intend this offering to last more than one year?
No
Item 9. Type(s) of Securities Offered
- Equity
- Security to be Acquired Upon Exercise of Option, Warrant or Other Right to Acquire Security
Item 10. Business Combination Transaction
Is this offering being made in connection with a business combination
transaction, such as a merger, acquisition or exchange offer?
No
Clarification of Response
Item 11. Minimum Investment
Minimum Investment accepted from any outside investor
0
Item 13. Offering and Sales Amounts
Total Offering Amount
10000000
Total Amount Sold
10000000
Total Remaining to be Sold
0
Clarification of Response
Item 14. Investors
Securities in the offering have been or may be sold to persons
who do not qualify as accredited investors,
Number of non-accredited investors who already have invested in the offering:
Total number of investors who already have invested in the offering:
2
Item 15. Sales Commissions and Finders' Fees Expenses
Sales Commissions:
0.0 Is an estimate
Finders' Fees
0.0 Is an estimate
Clarification of Response
Item 16. Use of Proceeds
Provide the amount of the gross proceeds of the offering
that has been or is proposed to be used for payments to any of the persons required
to be named as executive officers,directors or promoters in response to Item 3 above.
0.0 Is an estimate
Clarification of Response
Signature and Submission
Issuer Name
FORMA THERAPEUTICS HOLDINGS LLC
Issuer Signature
/S/ ANDREW LITTLEHALE
Signer Name
ANDREW LITTLEHALE
Signer Title
TREASURER
Signature Date
09/06/2012
