Filing Details
- Accession Number:
- 0000905718-21-001094
- Form Type:
- 4
- Zero Holdings:
- No
- Publication Time:
- 2021-08-17 12:38:51
- Reporting Period:
- 2021-08-16
- Accepted Time:
- 2021-08-17 12:38:51
- SEC Url:
- Form 4 Filing
Issuer
| Cik | Name | Symbol | Sector (SIC) | IRS No |
|---|---|---|---|---|
| 1853816 | Dermata Therapeutics Inc. | DRMA | Pharmaceutical Preparations (2834) | DE |
Insiders
| Cik | Name | Reported Address | Insider Title | Director | Officer | Large Shareholder | Other |
|---|---|---|---|---|---|---|---|
| 1279191 | T Gerald Proehl | 3525 Del Mar Heights Rd., #332 San Diego CA 92130 | President, Ceo And Chairman | Yes | Yes | Yes | No |
Reported Non-Derivative Transactions
| Sec. Name | Acquisiton - Disposition | Date | Amount | Price | Remaning Holdings | Equity Swap Involved | Form Type | Code | Nature of Ownership | Explanation |
|---|---|---|---|---|---|---|---|---|---|---|
| Common Stock | Acquisiton | 2021-08-16 | 10,000 | $4.96 | 10,000 | No | 4 | P | Indirect | By Proehl Family Trust |
| Common Stock | Acquisiton | 2021-08-17 | 17,857 | $0.00 | 17,857 | No | 4 | C | Indirect | By Allison Taylor Proehl 2020 Irrevocable Trust |
| Common Stock | Acquisiton | 2021-08-17 | 8,928 | $0.00 | 8,928 | No | 4 | C | Indirect | By Meghan Proehl Wilder 2020 Irrevocable Trust |
| Common Stock | Acquisiton | 2021-08-17 | 35,767 | $0.00 | 35,767 | No | 4 | C | Indirect | By Sean Michael Proehl 2020 Irrevocable Trust Dated December 18, 2020 |
| Common Stock | Acquisiton | 2021-08-17 | 361,147 | $0.00 | 1,278,464 | No | 4 | C | Indirect | By Proehl Investment Ventures LLC |
| Common Stock | Acquisiton | 2021-08-17 | 111,951 | $0.00 | 1,390,415 | No | 4 | C | Indirect | By Proehl Investment Ventures LLC |
| Common Stock | Acquisiton | 2021-08-17 | 181,585 | $0.00 | 1,572,000 | No | 4 | C | Indirect | By Proehl Investment Ventures LLC |
| Common Stock | Acquisiton | 2021-08-17 | 1,247,904 | $0.00 | 2,819,904 | No | 4 | C | Indirect | By Proehl Investment Ventures LLC |
| Common Stock | Acquisiton | 2021-08-17 | 85,640 | $0.00 | 2,905,544 | No | 4 | C | Indirect | By Proehl Investment Ventures LLC |
| Common Stock | Acquisiton | 2021-08-17 | 142,857 | $0.00 | 152,857 | No | 4 | P | Indirect | By Proehl Family Trust |
| Equity Swap Involved | Form Type | Code | Nature of Ownership | Explanation |
|---|---|---|---|---|
| No | 4 | P | Indirect | By Proehl Family Trust |
| No | 4 | C | Indirect | By Allison Taylor Proehl 2020 Irrevocable Trust |
| No | 4 | C | Indirect | By Meghan Proehl Wilder 2020 Irrevocable Trust |
| No | 4 | C | Indirect | By Sean Michael Proehl 2020 Irrevocable Trust Dated December 18, 2020 |
| No | 4 | C | Indirect | By Proehl Investment Ventures LLC |
| No | 4 | C | Indirect | By Proehl Investment Ventures LLC |
| No | 4 | C | Indirect | By Proehl Investment Ventures LLC |
| No | 4 | C | Indirect | By Proehl Investment Ventures LLC |
| No | 4 | C | Indirect | By Proehl Investment Ventures LLC |
| No | 4 | P | Indirect | By Proehl Family Trust |
Reported Derivative Transactions
| Sec. Name | Sec. Type | Acquisiton - Disposition | Date | Amount | Price | Amount - 2 | Price - 2 |
|---|---|---|---|---|---|---|---|
| Common Stock | Series 1d Preferred Stock | Disposition | 2021-08-17 | 120,481 | $0.00 | 17,857 | $0.00 |
| Common Stock | Series 1d Preferred Stock | Disposition | 2021-08-17 | 60,240 | $0.00 | 8,928 | $0.00 |
| Common Stock | Series 1d Preferred Stock | Disposition | 2021-08-17 | 241,325 | $0.00 | 35,767 | $0.00 |
| Common Stock | Series 1d Preferred Stock | Disposition | 2021-08-17 | 2,436,657 | $0.00 | 361,147 | $0.00 |
| Common Stock | Series 1a Preferred Stock | Disposition | 2021-08-17 | 2,295,000 | $0.00 | 111,951 | $0.00 |
| Common Stock | Series 1b Preferred Stock | Disposition | 2021-08-17 | 3,722,500 | $0.00 | 181,585 | $0.00 |
| Common Stock | Series 1c Preferred Stock | Disposition | 2021-08-17 | 25,582,050 | $0.00 | 1,247,904 | $0.00 |
| Common Stock | Series 1 Preferred Stock | Disposition | 2021-08-17 | 1,755,622 | $0.00 | 85,640 | $0.00 |
| Common Stock | Series 1a Warrants | Disposition | 2021-08-17 | 573,750 | $0.00 | 27,987 | $0.00 |
| Common Stock | Warrant to Purchase Common Stock | Acquisiton | 2021-08-17 | 27,987 | $0.00 | 27,987 | $20.50 |
| Common Stock | Warrant to Purchase Common Stock | Acquisiton | 2021-08-17 | 142,857 | $0.00 | 142,857 | $7.00 |
| Remaning Holdings | Exercise Date | Expiration Date | Equity Swap Involved | Transaction Form Type | Transaction Code | Nature of Ownership |
|---|---|---|---|---|---|---|
| 0 | No | 4 | C | Indirect | ||
| 0 | No | 4 | C | Indirect | ||
| 0 | No | 4 | C | Indirect | ||
| 0 | No | 4 | C | Indirect | ||
| 0 | No | 4 | C | Indirect | ||
| 0 | No | 4 | C | Indirect | ||
| 0 | No | 4 | C | Indirect | ||
| 0 | No | 4 | C | Indirect | ||
| 0 | 2016-11-15 | 2026-03-14 | No | 4 | C | Indirect |
| 27,987 | 2016-11-15 | 2026-03-14 | No | 4 | C | Indirect |
| 142,857 | 2021-08-17 | 2026-08-17 | No | 4 | P | Indirect |
Reported Non-Derivative Holdings
| Sec. Name | Remaning Holdings | Nature of Ownership | Explanation |
|---|---|---|---|
| Common Stock | 39,512 | Direct |
Footnotes
- The price reported in Column 4 is a weighted average price. These shares were purchased in multiple transactions at prices ranging from $4.84 to $5.00 per share, inclusive. The Reporting Person undertakes to provide to the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares purchased at each separate price within the ranges set forth herein.
- The Series 1d Preferred Stock automatically converted into Common Stock of the Issuer upon consummation of the Issuer's initial public offering (the "IPO"). The Series 1d Preferred Stock was convertible at any time and had no expiration date.
- The Series 1a Preferred Stock converted into Common Stock of the Issuer upon consummation of the IPO. The Series 1a Preferred Stock was convertible at any time and had no expiration date.
- The Series 1b Preferred Stock converted into Common Stock of the Issuer upon consummation of the IPO. The Series 1b Preferred Stock was convertible at any time and had no expiration date.
- The Series 1c Preferred Stock converted into Common Stock of the Issuer upon consummation of the IPO. The Series 1c Preferred Stock was convertible at any time and had no expiration date.
- The Series 1 Preferred Stock converted into Common Stock of the Issuer upon consummation of the IPO. The Series 1 Preferred Stock was convertible at any time and had no expiration date.
- The Series 1a Preferred Warrants converted into warrants to purchase Common Stock in connection with the IPO.
- Reporting Person disclaims beneficial ownership of these securities except to the extent of their pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose.
- Reporting Person purchased 142,857 Units in the IPO at $7.00 per Unit Each Unit consists of one share of Common Stock and one warrant to purchase one share of Common Stock.
Billionaire Hedge Funds
