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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Employee Stock Options (Right to buy) | $ 1.74 | 09/15/2016 | M | 287 | (4) | 02/06/2024 | Common Stock | 287 | $ 0 | 5,748 | D | ||||
Employee Stock Options (Right to buy) | $ 1.218 | 09/15/2016 | M | 1,016 | (5) | 01/03/2023 | Common Stock | 1,016 | $ 0 | 52,658 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Griffith Christopher M. C/O DERMIRA, INC. 275 MIDDLEFIELD ROAD, SUITE 150 MENLO PARK, CA 94025 |
VP Corp. Dev. & Strategy |
/s/ Christine Ring, by power of attorney | 09/16/2016 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | These trades were made pursuant to a Rule 10b5-1 trading plan. |
(2) | This transaction was executed in multiple trades at prices ranging from $32.97 to $33.74. The price reported above reflects the weighted average price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected. |
(3) | This transaction was executed in multiple trades at prices ranging from $31.67 to $32.45. The price reported above reflects the weighted average price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected. |
(4) | 25% of the total shares underlying the option vested and became exercisable on February 9, 2015 (the one-year anniversary of the vesting commencement date) and 1/48 of the total shares underlying the option vest and become exercisable each month thereafter, subject to the continuing employment of the Reporting person on the applicable vesting date. |
(5) | 25% of the total shares underlying the option vested and became exercisable on January 4, 2014 (the one-year anniversary of the vesting commencement date) and 1/48 of the total shares underlying the option vest and become exercisable each month thereafter, subject to the continuing employment of the Reporting person on the applicable vesting date. |