SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
ABERCROMBIE GEORGE B

(Last) (First) (Middle)
C/O BRICKELL BIOTECH, INC.
5777 CENTRAL AVENUE, SUITE 102

(Street)
BOULDER CO 80301

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
08/31/2019
3. Issuer Name and Ticker or Trading Symbol
Brickell Biotech, Inc. [ BBI ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
09/09/2019
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 7,230 D
Common Stock 12,082 I By Spouse as Trustee
Common Stock 12,082 I By Spouse as Trustee
Common Stock 107,030 I By Self As Trustee
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Options 01/25/2011 01/25/2021 Common Stock 8,630 2.9 D
Stock Options 02/14/2014 02/14/2024 Common Stock 2,589 6.37 D
Stock Options 04/22/2015 04/22/2025 Common Stock 8,630 12.17 D
Stock Options 12/15/2016 12/15/2026 Common Stock 3,452 12.17 D
Stock Options 12/15/2019 12/15/2028 Common Stock 5,178 16.45 D
Stock Options 08/30/2020 08/30/2029 Common Stock 34,521 4.76 D
Warrants 08/30/2019 08/30/2019 Common Stock 3,316 10.36 D
Explanation of Responses:
Remarks:
/s/ George B. Abercrombie 11/08/2019
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.