Sec Form 4 Filing - WIRTH PETER @ Forma Therapeutics Holdings, Inc., - 2020-06-23

Insider filing report for Changes in Beneficial Ownership
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FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
WIRTH PETER
2. Issuer Name and Ticker or Trading Symbol
Forma Therapeutics Holdings, Inc., [ FMTX]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
C/O FORMA THERAPEUTICS HOLDINGS, INC., 500 ARSENAL STREET, SUITE 100
3. Date of Earliest Transaction (MM/DD/YY)
06/23/2020
(Street)
WATERTOWN, MA02472
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 06/23/2020 P 63,299 A 127,665 D
Enterprise 1 Junior Stock 06/23/2020 S 25,756 D 0 D
Enterprise 2 Junior Stock 06/23/2020 S 18,585 D 0 D
Enterprise 3 Junior Stock 06/23/2020 S 9,847 D 0 D
Enterprise 4 Junior Stock 06/23/2020 S 10,240 D 0 D
Enterprise 5 Junior Stock 06/23/2020 S 14,026 D 0 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction Code
(Instr. 8)
5. Number of Derivative Securities Acqui red (A) or Disposed of (D)
(Instr. 3, 4, and 5)
6. Date Exercisable and Expiration Date
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
WIRTH PETER
C/O FORMA THERAPEUTICS HOLDINGS, INC.
500 ARSENAL STREET, SUITE 100
WATERTOWN, MA02472
X
Signatures
/s/ Jeannette Potts, as Attorney-in-Fact 06/24/2020
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Effective immediately upon the closing of the Registrant's initial public offering on June 23, 2020, the reporting person converted (i) 25,756 shares of Enterprise 1 Junior Stock at a conversion rate of 0.9006 shares of common stock per one share of Enterprise 1 Junior Stock, (ii) 18,585 shares of Enterprise 2 Junior Stock at a conversion rate of 0.8179 shares of common stock per one share of Enterprise 2 Junior Stock, (iii) 9,847 shares of Enterprise 3 Junior Stock at a conversion rate of 0.7822 shares of common stock per one share of Enterprise 3 Junior Stock, (iv) 10,240 shares of Enterprise 4 Junior Stock at a conversion rate of 0.7585 shares of common stock per one share of Enterprise 4 Junior Stock, and (v) 14,026 shares of Enterprise 5 Junior Stock at a conversion rate of 0.6727 shares of common stock per one share of Enterprise 5 Junior Stock, resulting in his acquisition of 63,299 shares of common stock.

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).

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