0001654954-22-009457.txt : 20220708 0001654954-22-009457.hdr.sgml : 20220708 20220708161026 ACCESSION NUMBER: 0001654954-22-009457 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220707 FILED AS OF DATE: 20220708 DATE AS OF CHANGE: 20220708 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Sandler Andrew Seth CENTRAL INDEX KEY: 0001596060 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40739 FILM NUMBER: 221074514 MAIL ADDRESS: STREET 1: 1301 2ND AVE CITY: SEATTLE STATE: WA ZIP: 98101 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Dermata Therapeutics, Inc. CENTRAL INDEX KEY: 0001853816 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3525 DEL MAR HEIGHTS RD., #322 CITY: SAN DIEGO STATE: CA ZIP: 92130 BUSINESS PHONE: (858)-223-0882 MAIL ADDRESS: STREET 1: 3525 DEL MAR HEIGHTS RD., #322 CITY: SAN DIEGO STATE: CA ZIP: 92130 4 1 section16.xml FORM 4 X0306 4 2022-07-07 0001853816 Dermata Therapeutics, Inc. DRMA 0001596060 Sandler Andrew Seth 3525 DEL MAR HEIGHTS RD. #322 SAN DIEGO CA 92130 true Common Stock, par value $0.0001 per share 2022-07-07 4 A false 8874 0 A 14064 D On July 7, 2022, the Reporting Person was granted 8,874 Common Stock restricted units pursuant to the Issuer's 2021 Omnibus Equity Incentive Plan. /s/ Gerald T. Proehl, Attorney-in-Fact 2022-07-08