0001567619-21-008372.txt : 20210420 0001567619-21-008372.hdr.sgml : 20210420 20210420174305 ACCESSION NUMBER: 0001567619-21-008372 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20210416 FILED AS OF DATE: 20210420 DATE AS OF CHANGE: 20210420 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: 21838916 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: 3027 TOWNSGATE ROAD STREET 2: SUITE 300 CITY: WESTLAKE VILLAGE STATE: CA ZIP: 91361 BUSINESS PHONE: 805-418-5006 MAIL ADDRESS: STREET 1: 3027 TOWNSGATE ROAD STREET 2: SUITE 300 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 2021-04-16 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 2021-04-16 4 M 0 391 1.6806 A 208677 D Common Stock 2021-04-16 4 M 0 1042 1.6806 A 209719 D Common Stock 2021-04-16 4 M 0 1222 0.5802 A 210941 D Common Stock 24991 I By Trust Stock Option (Right to Buy) 1.6806 2021-04-16 4 M 0 391 0.00 D 2029-03-13 Common Stock 391 10543 D Stock Option (Right to Buy) 1.6806 2021-04-16 4 M 0 1042 0.00 D 2029-03-13 Common Stock 1042 23949 D Stock Option (Right to Buy) 0.5802 2021-04-16 4 M 0 1222 0.00 D 2028-06-13 Common Stock 1222 20774 D Reflects cash exercise of stock option without the disposition of the underlying shares. Includes 6,750 Restricted Stock Units ("RSUs"). The Reporting Person is entitled to receive one (1) share of common stock for each one (1) RSU upon the vesting thereof. 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 a four year period beginning upon the achievement of certain company milestones, 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. The option began vesting on March 13, 2019 and will vest monthly over a four year period, 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. 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. Exhibit 24.1 - Power of Attorney /s/ Scott Burrows, as Attorney-in-Fact for Howard G. Welgus 2021-04-20 EX-24.1 2 poa_welgus.htm POWER OF ATTORNEY
Power of Attorney

Know all by these presents, that the undersigned hereby constitutes and appoints each of (i) the Chief Executive Officer, who is currently Todd Franklin Watanabe, of Arcutis Biotherapeutics, Inc., a Delaware corporation (the “Company”), (ii) the Company’s Chief Financial Officer, who is currently Scott Burrows, and (iii) the Company’s General Counsel, who is currently Keith Klein, and their respective successors (including anyone serving in such capacities on an interim or acting basis), signing singly, with full powers of substitution, as the undersigned’s true and lawful attorney-in-fact to:

 1.
prepare, execute in the undersigned’s name and on the undersigned’s behalf, and submit to the U.S. Securities and Exchange Commission (the “SEC”) a Form ID, including amendments thereto, and any other documents necessary or appropriate to obtain codes and passwords enabling the undersigned to make electronic filings with the SEC of reports required by Section 16(a) of the Securities Exchange Act of 1934 or any rule or regulation of the SEC;

2.
execute for and on behalf of the undersigned, in the undersigned’s capacity as an officer and/or director of the Company, Forms 3, 4, and 5 and any amendments thereto in accordance with Section 16(a) of the Securities Exchange Act of 1934 and the rules thereunder;

3.
do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Form 3, 4, or 5, complete and execute any amendment or amendments thereto, and timely file such form with the SEC and any stock exchange or similar authority; and

4.
take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-fact’s discretion.
The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact’s substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorneys-in-fact, in serving in such capacity at the request of the undersigned, are not assuming, nor is the Company assuming, any of the undersigned’s responsibilities to comply with Section 16 of the Securities Exchange Act of 1934.
This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4, and 5 with respect to the undersigned’s holdings of and transactions in securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 7th day of April, 2021.

/s/ Howard G. Welgus 
Howard G. Welgus