Maria Bedoya-Toro Munera - Aug 12, 2021 Form 3 Insider Report for Dermata Therapeutics, Inc. (DRMA)

Role
Senior VP
Signature
/s/ Gerald T. Proehl, Attorney-in Fact
Stock symbol
DRMA
Transactions as of
Aug 12, 2021
Transactions value $
$0
Form type
3
Date filed
8/12/2021, 07:43 PM
Next filing
Aug 17, 2021

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
holding DRMA Common Stock 30.5K Aug 12, 2021 Direct F1
holding DRMA Common Stock 19.5K Aug 12, 2021 By Munera Family Trust F1, F12

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) Aug 12, 2021 Common Stock 15.6K $5.74 Direct F1
holding DRMA Stock Option (Right to Buy) Aug 12, 2021 Common Stock 4.88K $5.74 Direct F1, F2
holding DRMA Stock Option (Right to Buy) Aug 12, 2021 Common Stock 2.44K $5.74 Direct F1, F3
holding DRMA Stock Option (Right to Buy) Aug 12, 2021 Common Stock 4.88K $5.74 Direct F1, F4
holding DRMA Stock Option (Right to Buy) Aug 12, 2021 Common Stock 4.88K $5.74 Direct F1, F5
holding DRMA Series 1d Preferred Stock Aug 12, 2021 Common Stock 61.8K By Munera Family Trust F6, F12
holding DRMA Series 1a Preferred Stock Aug 12, 2021 Common Stock 400K By Munera Family Trust F7, F12
holding DRMA Series 1b Preferred Stock Aug 12, 2021 Common Stock 100K By Munera Family Trust F8, F12
holding DRMA Series 1c Preferred Stock Aug 12, 2021 Common Stock 357K By Munera Family Trust F9, F12
holding DRMA Series 1 Preferred Stock Aug 12, 2021 Common Stock 280K By Munera Family Trust F10, F12
holding DRMA Series 1a Warrants Aug 12, 2021 Common Stock 100K By Munera Family Trust F11, F12
* 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 48 equal monthly installments commencing January 1, 2018.
F3 Options vest in 48 equal monthly installments commencing December 19, 2018.
F4 Options vest in 48 equal monthly installments commencing December 11, 2019.
F5 Options vest in 48 equal monthly installments commencing January 1, 2021.
F6 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"). All shares of Series 1d Preferred Stock will be converted into 9,162 shares of Common Stock of the Issuer upon consummation of the IPO. The conversion ratio reflects the Stock Split.
F7 The Series 1a Preferred Stock is convertible into shares of Common Stock in connection with the Issuer's IPO. All shares of Series 1a Preferred Stock will be converted into 19,512 shares of Common Stock of the Issuer upon consummation of the IPO. The conversion ratio reflects the Stock Split.
F8 The Series 1b Preferred Stock is convertible into shares of Common Stock in connection with the Issuer's IPO. All shares of Series 1b Preferred Stock will be converted into 4,878 shares of Common Stock of the Issuer upon consummation of the IPO. The conversion ratio reflects the Stock Split.
F9 The Series 1c Preferred Stock is convertible into shares of Common Stock in connection with the Issuer's IPO. All shares of Series 1c Preferred Stock will be converted into 17,421 shares of Common Stock of the Issuer upon consummation of the IPO. The conversion ratio reflects the Stock Split.
F10 The Series 1 Preferred Stock is convertible into shares of Common Stock in connection with the Issuer's IPO. All shares of Series 1 Preferred Stock will be converted into 13,658 shares of Common Stock of the Issuer upon consummation of the IPO. The conversion ratio reflects the Stock Split.
F11 The Series 1a Preferred Warrants are convertible into warrants to purchase Common Stock in connection with the Issuer's IPO. All Series 1a Preferred Warrants will be converted into warrants exercisable at $20.50 per share, to purchase up to 4,878 shares of Common Stock of the Issuer upon consummation of the IPO. The conversion ratio and exercise price reflect the Stock Split.
F12 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.

Remarks:

Exhibit 24-Power of Attorney