0000925421-17-000365.txt : 20170925 0000925421-17-000365.hdr.sgml : 20170925 20170925173017 ACCESSION NUMBER: 0000925421-17-000365 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170922 FILED AS OF DATE: 20170925 DATE AS OF CHANGE: 20170925 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ROSSI DINO A CENTRAL INDEX KEY: 0001209059 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38210 FILM NUMBER: 171100545 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Krystal Biotech, Inc. CENTRAL INDEX KEY: 0001711279 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 810930882 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2100 WHARTON STREET STREET 2: SUITE 701 CITY: PITTSBURGH STATE: PA ZIP: 15203 BUSINESS PHONE: (412) 586-5830 MAIL ADDRESS: STREET 1: 2100 WHARTON STREET STREET 2: SUITE 701 CITY: PITTSBURGH STATE: PA ZIP: 15203 4 1 edgar.xml PRIMARY DOCUMENT X0306 4 2017-09-22 0001711279 Krystal Biotech, Inc. KRYS 0001209059 ROSSI DINO A C/O KRYSTAL BIOTECH, INC. 2100 WHARTON STREET, SUITE 701 PITTSBURGH PA 15203 1 0 0 0 Common Stock 2017-09-22 4 C 0 123691 A 123691 D Series A Convertible Preferred Stock 2017-09-22 4 C 0 123691 0 D Common Stock 123691 0 D Stock Option (Right to Buy) 8.79 2021-06-01 2027-06-01 Common Stock 18949 18949 D The Series A convertible preferred stock converted on a one-to-one basis into 123,691 shares of common stock upon the closing of Krystal Biotech, Inc.'s initial public offering. /s/ Katherine A. Shaia, as attorney-in-fact for Dino A. Rossi 2017-09-25