0000819050-21-000087.txt : 20210614 0000819050-21-000087.hdr.sgml : 20210614 20210614164436 ACCESSION NUMBER: 0000819050-21-000087 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210614 FILED AS OF DATE: 20210614 DATE AS OF CHANGE: 20210614 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SAMANT VIJAY B CENTRAL INDEX KEY: 0001198238 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-21088 FILM NUMBER: 211015107 MAIL ADDRESS: STREET 1: 10390 PACIFIC CENTER COURT CITY: SAN DIEGO STATE: CA ZIP: 92121 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Brickell Biotech, Inc. CENTRAL INDEX KEY: 0000819050 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 930948554 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 5777 CENTRAL AVENUE STREET 2: SUITE 102 CITY: BOULDER STATE: CO ZIP: 80301 BUSINESS PHONE: (720) 505-4755 MAIL ADDRESS: STREET 1: 5777 CENTRAL AVENUE STREET 2: SUITE 102 CITY: BOULDER STATE: CO ZIP: 80301 FORMER COMPANY: FORMER CONFORMED NAME: VICAL INC DATE OF NAME CHANGE: 19940211 4 1 wf-form4_162370346407607.xml FORM 4 X0306 4 2021-06-14 0 0000819050 Brickell Biotech, Inc. BBI 0001198238 SAMANT VIJAY B C/O BRICKELL BIOTECH, INC. 5777 CENTRAL AVENUE, SUITE 102 BOULDER CO 80301 1 0 0 0 Stock Option (right to buy) 0.9 2021-06-14 4 A 0 40000 0 A 2022-06-14 2031-06-14 Common Stock 40000.0 40000 D /s/ Christine G. Long, Attorney-in-Fact for Vijay B. Samant (power of attorney previously filed) 2021-06-14