HALE DAVID F - 17 Aug 2021 Form 4 Insider Report for Dermata Therapeutics, Inc. (DRMA)

Role
Director, 10%+ Owner
Signature
/s/ Gerald T. Proehl, Attorney-in-Fact
Issuer symbol
DRMA
Transactions as of
17 Aug 2021
Net transactions value
$0
Form type
4
Filing time
17 Aug 2021, 12:49:46 UTC
Previous filing
12 Aug 2021
Next filing
10 Dec 2021
SEC
View on sec.gov

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
transaction DRMA Common Stock Conversion of derivative security +44,777 +18% 299,411 17 Aug 2021 By Hale BioVentures LLC F1, F7
transaction DRMA Common Stock Conversion of derivative security +12,195 +4.1% 311,606 17 Aug 2021 By Hale BioVentures LLC F2, F7
transaction DRMA Common Stock Conversion of derivative security +20,000 +6.4% 331,606 17 Aug 2021 By Hale BioVentures LLC F3, F7
transaction DRMA Common Stock Conversion of derivative security +174,216 +53% 505,822 17 Aug 2021 By Hale BioVentures LLC F4, F7
transaction DRMA Common Stock Conversion of derivative security +27,103 +5.4% 532,925 17 Aug 2021 By Hale BioVentures LLC F5, F7
transaction DRMA Common Stock Purchase +35,714 35,714 17 Aug 2021 By Hale Family Trust F7, F8
holding DRMA Common Stock 3,658 17 Aug 2021 Direct
holding DRMA Common Stock 12,195 17 Aug 2021 By Hale Trading Company LP F7

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 -302,112 -100% $0.000000* 0 17 Aug 2021 Common Stock 44,777 By Hale BioVentures LLC F1, F7
transaction DRMA Series 1a Preferred Stock Conversion of derivative security $0 -250,000 -100% $0.000000* 0 17 Aug 2021 Common Stock 12,195 By Hale BioVentures LLC F2, F7
transaction DRMA Series 1b Preferred Stock Conversion of derivative security $0 -410,000 -100% $0.000000* 0 17 Aug 2021 Common Stock 20,000 By Hale BioVentures LLC F3, F7
transaction DRMA Series 1c Preferred Stock Conversion of derivative security $0 -3,571,428 -100% $0.000000* 0 17 Aug 2021 Common Stock 174,216 By Hale BioVentures LLC F4, F7
transaction DRMA Series 1 Preferred Stock Conversion of derivative security $0 -555,622 -100% $0.000000* 0 17 Aug 2021 Common Stock 27,103 By Hale BioVentures LLC F5, F7
transaction DRMA Series 1a Warrants Conversion of derivative security $0 -62,500 -100% $0.000000* 0 17 Aug 2021 Common Stock 3,048 By Hale BioVentures LLC F6, F7
transaction DRMA Warrant to Purchase Common Stock Conversion of derivative security $0 +3,048 $0.000000 3,048 17 Aug 2021 Common Stock 3,048 $20.50 By Hale BioVentures LLC F7
transaction DRMA Warrant to Purchase Common Stock Purchase +35,714 35,714 17 Aug 2021 Common Stock 35,714 $7.00 By Hale Family Trust F7, F8
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 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.
F2 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.
F3 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.
F4 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.
F5 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.
F6 The Series 1a Preferred Warrants converted into warrants to purchase Common Stock in connection with the IPO.
F7 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.
F8 Reporting Person purchased 35,714 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.