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DRMA Dermata Therapeutics Inc

0.3423
0.0017 (0.50%)
Last Updated: 20:24:16
Delayed by 15 minutes
Share Name Share Symbol Market Type
Dermata Therapeutics Inc NASDAQ:DRMA NASDAQ Common Stock
  Price Change % Change Share Price Bid Price Offer Price High Price Low Price Open Price Shares Traded Last Trade
  0.0017 0.50% 0.3423 0.33 0.3423 0.342399 0.325 0.3406 45,345 20:24:16

Statement of Changes in Beneficial Ownership (4)

26/11/2021 6:31pm

Edgar (US Regulatory)


FORM 4 [ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).         
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
                                                                                  
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response...
0.5                       
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
                      

1. Name and Address of Reporting Person *

PROEHL GERALD T
2. Issuer Name and Ticker or Trading Symbol

Dermata Therapeutics, Inc. [ DRMA ]
5. Relationship of Reporting Person(s) to Issuer (Check all applicable)

__X__ Director                    __X__ 10% Owner
__X__ Officer (give title below)    _____ Other (specify below)
President, CEO and Chairman
(Last)          (First)          (Middle)

C/O DERMATA THERAPEUTICS, INC., 3525 DEL MAR HEIGHTS RD., #332
3. Date of Earliest Transaction (MM/DD/YYYY)

11/23/2021
(Street)

SAN DIEGO, CA 92130
(City)        (State)        (Zip)
4. If Amendment, Date Original Filed (MM/DD/YYYY)

 
6. Individual or Joint/Group Filing (Check Applicable Line)

_X _ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Trans. Date 2A. Deemed Execution Date, if any 3. Trans. Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 11/23/2021  P  20000 A$2.40 59512 D  
Common Stock         17857 I By Allison Taylor Proehl 2020 Irrevocable Trust (1)
Common Stock         8928 I By Meghan Proehl Wilder 2020 Irrevocable Trust (1)
Common Stock         35767 I By Sean Michael Proehl 2020 Irrevocable Trust Dated December 18, 2020 (1)
Common Stock         2905544 I By Proehl Investment Ventures LLC (1)
Common Stock         152857 I By Proehl Family Trust (1)

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivate Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security3. Trans. Date3A. Deemed Execution Date, if any4. Trans. Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
6. Date Exercisable and Expiration Date7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)11. Nature of Indirect Beneficial Ownership (Instr. 4)
CodeV(A)(D)Date ExercisableExpiration DateTitleAmount or Number of Shares

Explanation of Responses:
(1) Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose.

Reporting Owners
Reporting Owner Name / Address
Relationships
Director10% OwnerOfficerOther
PROEHL GERALD T
C/O DERMATA THERAPEUTICS, INC.
3525 DEL MAR HEIGHTS RD., #332
SAN DIEGO, CA 92130
XXPresident, CEO and Chairman

Signatures
/s/ Gerald T. Proehl11/26/2021
**Signature of Reporting PersonDate

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