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