0000905718-21-000665.txt : 20210513 0000905718-21-000665.hdr.sgml : 20210513 20210513160657 ACCESSION NUMBER: 0000905718-21-000665 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210303 FILED AS OF DATE: 20210513 DATE AS OF CHANGE: 20210513 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Mendelsohn Alan CENTRAL INDEX KEY: 0001842511 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37411 FILM NUMBER: 21919621 MAIL ADDRESS: STREET 1: C/O TIMBER PHARMACEUTICALS, INC. STREET 2: 50 TICE BLVD., SUITE A26 CITY: WOODCLIFF LAKE STATE: NJ ZIP: 07677 FORMER NAME: FORMER CONFORMED NAME: Mendelsohn Dr. Alan DATE OF NAME CHANGE: 20210126 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Timber Pharmaceuticals, Inc. CENTRAL INDEX KEY: 0001504167 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 593843182 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 110 ALLEN ROAD, SUITE 401 CITY: BASKING RIDGE STATE: NJ ZIP: 07920 BUSINESS PHONE: 914-205-3481 MAIL ADDRESS: STREET 1: 110 ALLEN ROAD, SUITE 401 CITY: BASKING RIDGE STATE: NJ ZIP: 07920 FORMER COMPANY: FORMER CONFORMED NAME: BioPharmX Corp DATE OF NAME CHANGE: 20140304 FORMER COMPANY: FORMER CONFORMED NAME: THOMPSON DESIGNS INC DATE OF NAME CHANGE: 20101022 4 1 timber_fm4mar32021.xml X0306 4 2021-03-03 0 0001504167 Timber Pharmaceuticals, Inc. TMBR 0001842511 Mendelsohn Alan 100 ALLEN ROAD, SUITE 401 BASKING RIDGE NJ 07920 0 1 0 0 Chief Medical Officer Common Stock, par value $0.001 per share 2021-03-03 4 P 0 1988 2.17 A 1988 I By spouse /s/ Joseph Lucchese, Power of Attorney 2021-05-13