0001104659-21-120469.txt : 20210929
0001104659-21-120469.hdr.sgml : 20210929
20210929080445
ACCESSION NUMBER: 0001104659-21-120469
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210927
FILED AS OF DATE: 20210929
DATE AS OF CHANGE: 20210929
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Lucchese Joseph
CENTRAL INDEX KEY: 0001810134
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37411
FILM NUMBER: 211289405
MAIL ADDRESS:
STREET 1: C/O TIMBER PHARMACEUTICALS, INC.
STREET 2: 900 E. HAMILTON AVENUE, SUITE 100
CITY: CAMPBELL
STATE: CA
ZIP: 95008
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Timber Pharmaceuticals, Inc.
CENTRAL INDEX KEY: 0001504167
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 593843182
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 110 ALLEN ROAD, SUITE 401
CITY: BASKING RIDGE
STATE: NJ
ZIP: 07920
BUSINESS PHONE: 914-205-3481
MAIL ADDRESS:
STREET 1: 110 ALLEN ROAD, SUITE 401
CITY: BASKING RIDGE
STATE: NJ
ZIP: 07920
FORMER COMPANY:
FORMER CONFORMED NAME: BioPharmX Corp
DATE OF NAME CHANGE: 20140304
FORMER COMPANY:
FORMER CONFORMED NAME: THOMPSON DESIGNS INC
DATE OF NAME CHANGE: 20101022
4
1
tm2128740-1_4seq1.xml
OWNERSHIP DOCUMENT
X0306
4
2021-09-27
0
0001504167
Timber Pharmaceuticals, Inc.
TMBR
0001810134
Lucchese Joseph
C/O TIMBER PHARMACEUTICALS, INC.
110 ALLEN ROAD, SUITE 401
BASKING RIDGE
NJ
07920
0
1
0
0
CFO, Executive VP & Treasurer
Stock Option (right to buy)
0.918
2021-09-27
4
A
0
361163
0
A
2031-09-26
Common Stock, par value $0.001 per share
361163
361163
D
25% of the options vest on September 27, 2022, and the remaining shares will become exercisable in equal 36 monthly installments beginning on October 27, 2022, as long as the reporting person remains continuously employed through each vesting date.
/s/ Joseph Lucchese
2021-09-29