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SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Hicks Laurence

(Last) (First) (Middle)
C/O ARCH THERAPEUTICS, INC.
235 WALNUT ST., SUITE

(Street)
FRAMINGHAM MA 01702

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
09/27/2021
3. Issuer Name and Ticker or Trading Symbol
Arch Therapeutics, Inc. [ ARTH ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 27,273 I Drake Partners Equity LLC(1)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (Right to Buy) (2) 09/26/2031 Common Stock 250,000 $0.1028 D
Stock Option (Right to Buy) (3) 04/22/2026 Common Stock 150,000 $0.125 I Hicks Family LLC(1)
Stock Option (Right to Buy) (3) 01/27/2026 Common Stock 100,000 $0.19 I Hicks Family LLC(1)
Explanation of Responses:
1. Reporting person may be deemed to be a control person of this entity.
2. The option was granted pursuant to the Issuer's 2013 Stock Incentive Plan (the "Plan"). The option shall vest equally on each of the first 36 month anniversaries of the grant date, subject to continued service to the Issuer through each vesting date. In the event of a Change of Control (as such term is defined in the Plan), 100% of the number of unvested shares then subject to the option shall accelerate and become immediately exercisable.
3. The option was granted pursuant to the Plan. The option vests equally on each of the first four three-month anniversaries of the grant date.
/s/ Laurence Hicks 10/12/2021
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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 Number.