0001567619-21-001012.txt : 20210114
0001567619-21-001012.hdr.sgml : 20210114
20210114111103
ACCESSION NUMBER: 0001567619-21-001012
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210112
FILED AS OF DATE: 20210114
DATE AS OF CHANGE: 20210114
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Welgus Howard G.
CENTRAL INDEX KEY: 0001801050
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39186
FILM NUMBER: 21527865
MAIL ADDRESS:
STREET 1: C/O ARCUTIS BIOTHERAPEUTICS, INC.
STREET 2: 2945 TOWNSGATE ROAD, SUITE 110
CITY: WESTLAKE VILLAGE
STATE: CA
ZIP: 91361
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Arcutis Biotherapeutics, Inc.
CENTRAL INDEX KEY: 0001787306
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 812974255
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 2945 TOWNSGATE ROAD
STREET 2: SUITE 110
CITY: WESTLAKE VILLAGE
STATE: CA
ZIP: 91361
BUSINESS PHONE: 805-418-5006
MAIL ADDRESS:
STREET 1: 2945 TOWNSGATE ROAD
STREET 2: SUITE 110
CITY: WESTLAKE VILLAGE
STATE: CA
ZIP: 91361
FORMER COMPANY:
FORMER CONFORMED NAME: Arcutis, Inc.
DATE OF NAME CHANGE: 20190905
4
1
doc1.xml
FORM 4
X0306
4
2021-01-12
0
0001787306
Arcutis Biotherapeutics, Inc.
ARQT
0001801050
Welgus Howard G.
C/O ARCUTIS BIOTHERAPEUTICS, INC.
3027 TOWNSGATE ROAD, SUITE 300
WESTLAKE VILLAGE
CA
91361
1
0
0
0
Common Stock
2021-01-12
4
M
0
1222
0.5802
A
183118
D
Common Stock
24991
I
By Trust
Stock Option (Right to Buy)
0.5802
2021-01-12
4
M
0
1222
0.00
D
2028-06-13
Common Stock
1222
24440
D
Reflects cash exercise of stock option without the disposition of the underlying shares.
The securities are held of record by The Welgus Living Trust, of which the Reporting Person is trustee. The Reporting Person disclaims beneficial ownership of such securities except to the extent of his pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of such securities for purposes of Section 16 or for any other purposes.
The option began vesting monthly over 35 months beginning July 11, 2019, subject to the Reporting Person's continuous provision of services to the Issuer on each vesting date. The option contains an early-exercise provision and is exercisable as to unvested shares, subject to the Issuer's right of repurchase.
/s/ John W. Smither, as Attorney-in-Fact for Howard G. Welgus
2021-01-13