0001209191-21-016984.txt : 20210303 0001209191-21-016984.hdr.sgml : 20210303 20210303170336 ACCESSION NUMBER: 0001209191-21-016984 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210301 FILED AS OF DATE: 20210303 DATE AS OF CHANGE: 20210303 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Goldenberg Gary CENTRAL INDEX KEY: 0001741938 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38529 FILM NUMBER: 21710167 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 2021-03-01 0 0001660334 Verrica Pharmaceuticals Inc. VRCA 0001741938 Goldenberg Gary C/O VERRICA PHARMACEUTICALS INC. 10 NORTH HIGH STREET, SUITE 200 WEST CHESTER PA 19380 0 1 0 0 Chief Medical Officer Employee Stock Option (Right to Buy) 14.32 2021-03-01 4 A 0 65000 0.00 A 2031-02-28 Common Stock 65000 65000 D 25% of the total shares subject to the option shall vest on March 1, 2022 and 1/48th of the total shares subject to the option shall vest monthly thereafter over the remaining three years of the vesting period, subject to the Reporting Person's continuous service through such vesting date. /s/ Mark Ballantyne, Attorney-in-Fact 2021-03-03