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Dermata Therapeutics, Inc. Director's Dealing 2021

Aug 13, 2021

35467_dirs_2021-08-12_c57ff5d1-1cd6-4093-819f-a5fd91260088.zip

Director's Dealing

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SEC Form 3 — Initial Statement of Beneficial Ownership

Issuer: Dermata Therapeutics, Inc. (DRMA)
CIK: 0001853816
Period of Report: 2021-08-12

Reporting Person: WIERENGA WENDELL (Director)

Holdings (Non-Derivative)

Security Shares Ownership
Common Stock 4878 Direct

Holdings (Derivative)

Security Exercise Price Expiration Underlying Shares Ownership
Stock Option (Right to Buy) $5.74 2031-03-31 Common Stock (12194) Direct
Stock Option (Right to Buy) $5.74 2031-03-31 Common Stock (4878) Direct
Series 1d Preferred Stock $ Common Stock (55078) Direct

Footnotes

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.