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