0001209191-22-009596.txt : 20220214
0001209191-22-009596.hdr.sgml : 20220214
20220214211540
ACCESSION NUMBER: 0001209191-22-009596
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211231
FILED AS OF DATE: 20220214
DATE AS OF CHANGE: 20220214
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Manning Paul B
CENTRAL INDEX KEY: 0001494695
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38529
FILM NUMBER: 22636713
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: 10 NORTH HIGH STREET
STREET 2: SUITE 200
CITY: WEST CHESTER
STATE: PA
ZIP: 19380
BUSINESS PHONE: 484-453-3300
MAIL ADDRESS:
STREET 1: 10 NORTH HIGH STREET
STREET 2: SUITE 200
CITY: WEST CHESTER
STATE: PA
ZIP: 19380
5
1
doc5.xml
FORM 5 SUBMISSION
X0306
5
2021-12-31
0
0
0
0001660334
Verrica Pharmaceuticals Inc.
VRCA
0001494695
Manning Paul B
200 GARRETT STREET, SUITE S
CHARLOTTESVILLE
VA
22902
1
0
1
0
Common Stock
2021-07-06
5
G
0
739830
0.00
D
0
I
See footnote
Common Stock
2021-07-06
5
G
0
739830
0.00
A
8889224
D
The securities are held by The Paul B. Manning Revocable Trust dated May 10, 2000 (the "Trust"). The Reporting Person is the trustee of the Trust and has sole voting and investment power with respect to the shares held by the Trust.
Consists of 7,754,783 shares of common stock held by Mr. Manning and 1,134,441 shares of common stock held by Mr. Manning jointly with his spouse.
/s/ Mark Ballantyne, Attorney-in-Fact
2022-02-14