0001104659-22-047218.txt : 20220419 0001104659-22-047218.hdr.sgml : 20220419 20220419125952 ACCESSION NUMBER: 0001104659-22-047218 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220415 FILED AS OF DATE: 20220419 DATE AS OF CHANGE: 20220419 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Cohen David E CENTRAL INDEX KEY: 0001347383 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37411 FILM NUMBER: 22834130 MAIL ADDRESS: STREET 1: 3160 PORTER DRIVE CITY: PALO ALTO STATE: CA ZIP: 94304 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 tm2212708-5_4seq1.xml OWNERSHIP DOCUMENT X0306 4 2022-04-15 0 0001504167 Timber Pharmaceuticals, Inc. TMBR 0001347383 Cohen David E C/O TIMBER PHARMACEUTICALS, INC 110 ALLEN ROAD, SUITE 401 BASKING RIDGE NJ 07920 1 0 0 0 Common Stock, par value $0.001 per share 2022-04-15 4 A 0 100000 0 A 100000 D Stock Option (right to buy) 0.307 2022-04-15 4 A 0 100000 0 A 2032-04-14 Common Stock, par value $0.001 per share 100000 100000 D On April 15, 2022, the Reporting Person was granted 100,000 restricted stock units, which will be settled in shares of common stock, par value $0.001, of Timber Pharmaceuticals, Inc. (the "Issuer"). The restricted stock units vest in 12 equal monthly installments beginning on May 15, 2022, as long as the Reporting Person remains in continuous service with the Issuer through each vesting date. 25% of the options vest on April 15, 2023, and the remaining shares will become exercisable in 24 equal monthly installments beginning on May 15, 2023, as long as the Reporting Person remains in continuous service with the Issuer through each vesting date. /s/ Joseph Lucchese, Power of Attorney 2022-04-19