SEC Form 4 · accession 0001562180-16-003001
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
Aug 15, 2016
Accepted (ET)
Aug 16, 2016 · 4:14 pm EDT
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 Stock | Aug 15, 2016 | M | 3,000 | $0.00 | A | 6,512 | D | |
| Common StockF1 | Aug 15, 2016 | F | 1,128 | $31.59 | D | 5,384 | D | |
| Common StockF2 | holding | — | — | — | 178,180 | I | By the Wiggans Living Trust dated 5/14/02 | |
| Common StockF3 | holding | — | — | — | 8,620 | I | By the Amanda Wiggans Irrevocable Gifting Trust dated 2/24/11 | |
| Common StockF3 | holding | — | — | — | 8,620 | I | By the Elizabeth Wiggans Irrevocable Gifting Trust dated 2/24/11 |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Restricted Stock UnitF4,F5 | — | Aug 15, 2016 | M | 3,000 | D | — | — | Common Stock | 3,000 | 27,000 | D |
Explanation of responses
- F1These shares include prior ESPP purchases.
- F2The Reporting Person is a Co-Trustee.
- F3The Reporting Person has no voting or dispositive power over the shares held by the trust.
- F4Each RSU represents a contingent right to receive one share of DERM common stock.
- F5Vested as to 10% of the shares on August 15, 2016, Will vest 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.