0001209191-18-038593.txt : 20180619
0001209191-18-038593.hdr.sgml : 20180619
20180619164648
ACCESSION NUMBER: 0001209191-18-038593
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180619
FILED AS OF DATE: 20180619
DATE AS OF CHANGE: 20180619
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Manning Paul B
CENTRAL INDEX KEY: 0001494695
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38529
FILM NUMBER: 18907672
MAIL ADDRESS:
STREET 1: 200 GARRETT STREET SUITE S
CITY: CHARLOTTESVILLE
STATE: VA
ZIP: 22902
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Verrica Pharmaceuticals Inc.
CENTRAL INDEX KEY: 0001660334
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 463137900
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 200 GARRETT STREET
CITY: CHARLOTTESVILLE
STATE: VA
ZIP: 22902
BUSINESS PHONE: 434-980-8100
MAIL ADDRESS:
STREET 1: 200 GARRETT STREET
CITY: CHARLOTTESVILLE
STATE: VA
ZIP: 22902
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2018-06-19
0
0001660334
Verrica Pharmaceuticals Inc.
VRCA
0001494695
Manning Paul B
200 GARRETT STREET, SUITE S
CHARLOTTESVILLE
VA
22902
1
0
1
0
Common Stock
2018-06-19
4
C
0
7754783
A
7754783
D
Common Stock
2018-06-19
4
C
0
1132900
A
1160244
I
See Footnote
Common Stock
2018-06-19
4
C
0
256634
A
256634
I
See Footnote
Series A Convertible Preferred Stock
2018-06-19
4
C
0
7754783
0.00
D
Common Stock
7754783
0
D
Series A Convertible Preferred Stock
2018-06-19
4
C
0
1132900
0.00
D
Common Stock
1132900
0
I
See Footnote
Series A Convertible Preferred Stock
2018-06-19
4
C
0
256634
0.00
D
Common Stock
256634
0
I
See Footnote
Each share of Series A Convertible Preferred Stock was convertible at any time at the option of the holder into Common Stock, had no expiration date and converted into shares of Common Stock upon the closing of the Issuer's initial public offering.
The shares are held directly by BKB Growth Investments, LLC ("BKB"). The Reporting Person is a co-manager of BKB and has sole voting and investment power with respect to the shares held by BKB.
The shares are held directly by PBM Capital Investments, LLC ("PBMCI"). The Reporting Person is President and CEO of PBMCI and has sole voting and investment power with respect to the shares held by PBMCI.
/s/ Edward Sniezek, Attorney-in-Fact
2018-06-19