0001567619-21-013907.txt : 20210723 0001567619-21-013907.hdr.sgml : 20210723 20210723174746 ACCESSION NUMBER: 0001567619-21-013907 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210316 FILED AS OF DATE: 20210723 DATE AS OF CHANGE: 20210723 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Welgus Howard G. CENTRAL INDEX KEY: 0001801050 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-39186 FILM NUMBER: 211111790 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/A 1 doc1.xml FORM 4/A X0306 4/A 2021-03-16 2021-03-18 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 181896 D Common Stock 24991 I By Trust Stock Option (Right to Buy) 0.5802 2028-06-13 Common Stock 25662 25662 D Stock Option (Right to Buy) 1.6806 2029-03-13 Common Stock 44982 44982 D Stock Option (Right to Buy) 1.6806 2029-03-13 Common Stock 13667 13667 D Option exercises unwound as the transaction was not authorized by the Reporting Person. This Form 4/A corrects the aforementioned error by removing the transactions and adjusting the Reporting Person's ownership accordingly. 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 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. 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 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. /s/ Howard G. Welgus 2021-07-23