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
OMB APPROVAL
OMB Number: 3235-0104
Estimated average burden
hours per response: 0.5
1. Name and Address of Reporting Person*
MANCINI ALEXANDRA DIANE JANET

(Last) (First) (Middle)
C/O INMED PHARMACEUTICALS INC.
SUITE 310 - 815 HASTINGS STREET

(Street)
VANCOUVER A1 V6C 1B4

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
11/12/2020
3. Issuer Name and Ticker or Trading Symbol
InMed Pharmaceuticals Inc. [ INM ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Sr VP, Clinical/Reg Affairs
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 Shares 6,061 D
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
Employee Stock Option (Right to Buy) 02/20/2017 02/20/2022 Common Shares 3,030 $9.36(1) D
Employee Stock Option (Right to Buy) 06/02/2017 06/02/2022 Common Shares 1,515 $11.39(2) D
Employee Stock Option (Right to Buy) 03/08/2018 03/08/2023 Common Shares 1,515 $39.23(3) D
Employee Stock Option (Right to Buy) 05/16/2018 05/16/2023 Common Shares 12,121 $25.81(4) D
Employee Stock Option (Right to Buy) 01/21/2019(8) 01/21/2024 Common Shares 3,030 $12.91(5) D
Employee Stock Option (Right to Buy) 05/27/2019(9) 05/26/2024 Common Shares 12,121 $11.01(6) D
Employee Stock Option (Right to Buy) 10/28/2016 10/28/2021 Common Shares 12,121 $4.94(7) D
Explanation of Responses:
1. Converted from Canadian exercise price of C$12.21 using an exchange rate of C$1.3039 = US$1.00.
2. Converted from Canadian exercise price of C$14.85 using an exchange rate of C$1.3039 = US$1.00.
3. Converted from Canadian exercise price of C$51.15 using an exchange rate of C$1.3039 = US$1.00.
4. Converted from Canadian exercise price of C$33.66 using an exchange rate of C$1.3039 = US$1.00.
5. Converted from Canadian exercise price of C$16.83 using an exchange rate of C$1.3039 = US$1.00.
6. Converted from Canadian exercise price of C$14.36 using an exchange rate of C$1.3039 = US$1.00.
7. Converted from Canadian exercise price of C$6.44 using an exchange rate of C$1.3039 = US$1.00.
8. 758 of the options will vest on January 21, 2021.
9. 3,030 of the options will vest on each of November 27, 2020 and May 27, 2021.
Remarks:
Exhibit 24.1 Power of Attorney
/s/ Alexander Diane Janet Mancini 11/12/2020
** 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.