0001209191-19-015808.txt : 20190304 0001209191-19-015808.hdr.sgml : 20190304 20190304172933 ACCESSION NUMBER: 0001209191-19-015808 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190228 FILED AS OF DATE: 20190304 DATE AS OF CHANGE: 20190304 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: White Ted CENTRAL INDEX KEY: 0001741964 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38529 FILM NUMBER: 19655312 MAIL ADDRESS: STREET 1: C/O VERRICA PHARMACEUTICALS INC. STREET 2: 10 NORTH HIGH STREET, SUITE 200 CITY: WEST CHESTER STATE: PA ZIP: 19380 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 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2019-02-28 0 0001660334 Verrica Pharmaceuticals Inc. VRCA 0001741964 White Ted C/O VERRICA PHARMACEUTICALS INC. 10 NORTH HIGH STREET, SUITE 200 WEST CHESTER PA 19380 1 1 0 0 President and CEO Employee Stock Option (Right to Buy) 11.32 2019-02-28 4 A 0 100000 0.00 A 2029-02-27 Common Stock 100000 100000 D 25% of shares subject to the option shall vest on February 28, 2020 (the "Initial Vesting Date"), and 1/48th of the shares subject to the Option shall vest each month thereafter on the same day of the month as the Initial Vesting Date, subject to the Reporting Person continuing to be a service provider through each such date. /s/ Mark Ballantyne, Attorney-in-Fact 2019-03-04