Form D

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

Previous Name(s)

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)
  • EXECUTIVE OFFICER
Clarification of Response

Item 3. Related Persons

Name
PETER FINN
Address
subscription required
Relationship(s)
  • EXECUTIVE OFFICER
Clarification of Response

Item 3. Related Persons

Name
STEVEN HALL
Address
subscription required
Relationship(s)
  • DIRECTOR
Clarification of Response

Item 3. Related Persons

Name
REINHARD AMBROS, PH.D.
Address
subscription required
Relationship(s)
  • DIRECTOR
Clarification of Response

Item 3. Related Persons

Name
THONG-YUEN POON
Address
subscription required
Relationship(s)
  • DIRECTOR
Clarification of Response

Item 3. Related Persons

Name
MICHAEL A. FOLEY
Address
subscription required
Relationship(s)
  • DIRECTOR
Clarification of Response

Item 3. Related Persons

Name
ALEXIS BORISY
Address
subscription required
Relationship(s)
  • DIRECTOR
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:
12/30/2011

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

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?
Yes
Clarification of Response
CORPORATE REORGANIZATION. NO CASH CONSIDERATION WAS PROVIDED AND NO NON-AFFILIATED THIRD PARTIES WERE INVOLVED.

Item 11. Minimum Investment

Minimum Investment accepted from any outside investor
0

Item 13. Offering and Sales Amounts

Total Offering Amount
50053000
Total Amount Sold
50053000
Total Remaining to be Sold
0
Clarification of Response
NO CASH CONSIDERATION WAS RECEIVED BY THE ISSUER IN CONNECTION WITH THIS OFFERING. COMMON STOCK, SERIES A PREFERRED STOCK AND SERIES B PREFERRED STOCK WERE ISSUED IN EXCHANGE FOR SHARES OF FORMA THERAPEUTICS, INC.

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:
20

Item 15. Sales Commissions and Finders' Fees Expenses

Sales Commissions:
0.0
Finders' Fees
0.0
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
01/06/2012

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