SEC Form 4 · accession 0001562180-16-001565
Dermira, Inc. · DERM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Thomas G Wiggans
Officer — CEO & Chairman of the Board · Director
Period of report
Feb 5, 2016
Accepted (ET)
Feb 9, 2016 · 6:35 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001557883
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | holding | — | — | — | 2,355 | D | ||
| Common StockF2 | holding | — | — | — | 8,620 | I | Amanda Wiggans Irrevocable Gifting Trust dated 2/24/11 | |
| Common StockF2 | holding | — | — | — | 8,620 | I | Elizabeth Wiggans Irrevocable Gifting Trust dated 2/24/11 | |
| Common StockF3 | holding | — | — | — | 238,180 | I | Wiggans Living Trust dated 5/14/02 |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Employee Stock Options (Right to buy)F4 | $26.37 | Feb 5, 2016 | A | 180,000 | A | — | Feb 4, 2026 | Common Stock | 180,000 | 180,000 | D |
| Restricted Stock UnitF5,F6 | — | Feb 5, 2016 | A | 30,000 | A | — | — | Common Stock | 30,000 | 30,000 | D |
Explanation of responses
- F1These shares represent prior ESPP purchases.
- F2The Reporting Person has no voting or dispositive power over the shares held by the trust.
- F3The Reporting Person is a Co-Trustee.
- F4The stock option vests and becomes exercisable as to 1/48th of the shares in equal monthly installments with the first 1/48th of the shares vesting on February 1, 2016, subject to the continuing employment of the Reporting person on the applicable vesting date.
- F5Each RSU represents a contingent right to receive one share of DERM common stock.
- F6Vests as to 10% of the shares on August 15, 2016, 30% on August 15, 2017, 30% on August 15, 2018, 30% on August 15,2019, subject to the continuing employment of the Reporting Person on each vesting date.