Wendell Wierenga - 12 Aug 2021 Form 3 Insider Report for Dermata Therapeutics, Inc. (DRMA)

Role
Director
Signature
/s/ Gerald T. Proehl, Attorney-in Fact
Issuer symbol
DRMA
Transactions as of
12 Aug 2021
Net transactions value
$0
Form type
3
Filing time
12 Aug 2021, 19:28:27 UTC
Next filing
17 Aug 2021
SEC
View on sec.gov

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
holding DRMA Common Stock 4,878 12 Aug 2021 Direct F1

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Underlying Class Amount Exercise Price Ownership Footnotes
holding DRMA Stock Option (Right to Buy) 12 Aug 2021 Common Stock 12,194 $5.74 Direct F1
holding DRMA Stock Option (Right to Buy) 12 Aug 2021 Common Stock 4,878 $5.74 Direct F1, F2
holding DRMA Series 1d Preferred Stock 12 Aug 2021 Common Stock 55,078 Direct F3
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 Shares reported reflect the 1 for 20.5 stock split effected July 1, 2021 (the "Stock Split").
F2 Options vest in 12 equal monthly installments commencing January 1, 2021.
F3 The Series 1d Preferred Stock is convertible into shares of Common Stock at a conversion ratio equal to 80% of the offering price in connection with the Issuer's initial public offering ("IPO"). Upon filing of the Issuer's Restated Certificate of Incorporation in connection with the IPO, all shares of Series 1d Preferred Stock will be converted into 8,163 shares of Common Stock of the Issuer. The conversion ratio reflects the Stock Split.

Remarks:

Exhibit 24. Power of Attorney