0000905718-22-000052.txt : 20220105 0000905718-22-000052.hdr.sgml : 20220105 20220105192239 ACCESSION NUMBER: 0000905718-22-000052 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220103 FILED AS OF DATE: 20220105 DATE AS OF CHANGE: 20220105 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Nardo Christopher J. CENTRAL INDEX KEY: 0001870247 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40739 FILM NUMBER: 22513094 MAIL ADDRESS: STREET 1: C/O DERMATA THERAPEUTICS, INC. STREET 2: 3525 DEL MAR HEIGHTS RD., #322 CITY: SAN DIEGO STATE: CA ZIP: 92130 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Dermata Therapeutics, Inc. CENTRAL INDEX KEY: 0001853816 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3525 DEL MAR HEIGHTS RD., #322 CITY: SAN DIEGO STATE: CA ZIP: 92130 BUSINESS PHONE: (858)-223-0882 MAIL ADDRESS: STREET 1: 3525 DEL MAR HEIGHTS RD., #322 CITY: SAN DIEGO STATE: CA ZIP: 92130 4 1 dermata_fm4jan32022.xml X0306 4 2022-01-03 0 0001853816 Dermata Therapeutics, Inc. DRMA 0001870247 Nardo Christopher J. 3525 DEL MAR HEIGHTS RD., #332 SAN DIEGO CA 92130 0 1 0 0 Senior VP, Development Stock Option (right to buy) 1.88 2022-01-03 4 A 0 30000 0 A 2032-01-02 Common Stock 30000 30000 D The option will vest as to 40% upon the 12 month anniversary of the grant date, and will vest as to 60% in 36 equal monthly installments commencing on the 12 month anniversary of the grant date. /s/ Gerald T. Proehl, Attorney-in-Fact 2022-01-05