Zachary Rome - 04 Mar 2022 Form 4 Insider Report for Timber Pharmaceuticals, Inc.

Reporting relationship: Director
Issuer ticker: N/A
Reported as of: 04 Mar 2022
Net transaction value: -$4,703
SEC form: 4
Accepted by SEC: 15 Apr 2022, 16:10:26 UTC
Prior SEC filing: 16 Sep 2021
Next SEC filing: 14 Oct 2022
Source filing: View source filing
Reporting owner signature: /s/ Joseph Lucchese, Power of Attorney

Key filing fact

Zachary Rome filed Form 4 for Timber Pharmaceuticals, Inc. on 15 Apr 2022.

Key facts

This page summarizes Zachary Rome's Form 4 filing for Timber Pharmaceuticals, Inc..
4 reported transactions and 2 derivative rows are listed below.
Accepted by SEC: 15 Apr 2022, 16:10.

Change

Previous filing in this sequence was filed on 16 Sep 2021.
Current net transaction value: -$4,703.

Research use

This tells you what this filing adds before you inspect full transaction and derivative tables.
You can trace every row back to the original SEC filing document.

Evidence

Filed on Form 4

Ownership activity is grounded in SEC Form 4 disclosures.

View source filing

Reported non-derivative transactions

Shares, units, or other non-derivative securities reported in this filing.

TMBR transaction

Common Stock, par value $0.001 per share

Options Exercise

Transaction value: $793
Shares: +79,326
Change %
Price: $0.0100^*
Shares after: 79,326
Date: 04 Mar 2022
Ownership: Direct

TMBR transaction

Common Stock, par value $0.001 per share

Tax liability

Transaction value: $5,496
Shares: -19,630
Change %: -25%
Price: $0.2800^*
Shares after: 59,696
Date: 04 Mar 2022
Ownership: Direct
Footnotes: F1

Reported derivative securities

Options, warrants, convertible securities, or similar derivative positions disclosed in the filing.

TMBR transaction Derivative

Value Appreciation Rights

Disposed to Issuer

Transaction value: $0
Shares: -52,884
Change %: -40%
Price: $0.000000
Shares after: 79,326
Date: 04 Mar 2022
Ownership: Direct
Underlying class: Common Stock, par value $0.001 per share
Underlying amount: 52,884
Exercise price: $0.0100
Footnotes: F2

TMBR transaction Derivative

Value Appreciation Rights

Options Exercise

Transaction value: $0
Shares: +79,326
Change %
Price: $0.000000^*
Shares after: 0
Date: 04 Mar 2022
Ownership: Direct
Underlying class: Common Stock, par value $0.001 per share
Underlying amount: 79,326
Exercise price: $0.0100
Footnotes: F2

^* marks a reported price that did not pass the local price check.

Additional SEC filing notes

Filing notes and footnotes

Explanation of responses 2 footnotes

Footnote F1

Represents shares of common stock, par value $0.001 per share (the "Common Stock") of Timber Pharmaceuticals, Inc. (the "Issuer") withheld by the Issuer to satisfy tax withholding obligations on the exercise of value appreciation rights ("VARs").

Footnote F2

The VARs were to vest in five equal annual installments commencing on March 1, 2019, so long as the Reporting Person remained employed by the Issuer or its affiliates. The Reporting Person stepped down from his positions as the Chief Operating Officer and Executive Vice President of the Issuer effective March 4, 2022. As a result, the VARs were exercisable as of March 4, 2022.