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