Thomas Insley - Aug 17, 2021 Form 4 Insider Report for Dermata Therapeutics, Inc. (DRMA)

Signature
/s/ Gerald T. Proehl, Attorney-in-Fact
Stock symbol
DRMA
Transactions as of
Aug 17, 2021
Transactions value $
$0
Form type
4
Date filed
8/17/2021, 12:40 PM
Previous filing
Aug 12, 2021

Transactions Table

Type Sym Class Transaction Value $ Shares Change % Price $ Shares After Date Ownership Footnotes
transaction DRMA Common Stock Conversion of derivative security +4.58K +46.96% 14.3K Aug 17, 2021 By Insley Family Trust F1, F2

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
transaction DRMA Series 1d Preferred Stock Conversion of derivative security $0 -30.9K -100% $0.00 0 Aug 17, 2021 Common Stock 4.58K By Insley Family Trust F1, F2

Explanation of Responses:

Id Content
F1 The Series 1d Preferred Stock 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.
F2 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.