0001209191-18-038600.txt : 20180619
0001209191-18-038600.hdr.sgml : 20180619
20180619165011
ACCESSION NUMBER: 0001209191-18-038600
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: Stalfort Sean
CENTRAL INDEX KEY: 0001709418
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38529
FILM NUMBER: 18907701
MAIL ADDRESS:
STREET 1: C/O DOVA PHARMACEUTICALS, INC.
STREET 2: 240 LEIGH FARM ROAD, SUITE 245
CITY: DURHAM
STATE: NC
ZIP: 27707
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
0001709418
Stalfort Sean
C/O VERRICA PHARMACEUTICALS INC.
10 NORTH HIGH STREET, SUITE 200
WEST CHESTER
PA
19380
1
0
0
0
Common Stock
2018-06-19
4
C
0
394295
A
421639
D
Series A Convertible Preferred Stock
2018-06-19
4
C
0
394295
0.00
D
Common Stock
394295
0
D
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.
/s/ Edward Sniezek, Attorney-in-Fact
2018-06-19