0001012975-17-000155.txt : 20170223 0001012975-17-000155.hdr.sgml : 20170223 20170223184645 ACCESSION NUMBER: 0001012975-17-000155 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170221 FILED AS OF DATE: 20170223 DATE AS OF CHANGE: 20170223 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: IMPINJ INC CENTRAL INDEX KEY: 0001114995 STANDARD INDUSTRIAL CLASSIFICATION: ELECTRONIC COMPONENTS, NEC [3679] IRS NUMBER: 912041398 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 400 FAIRVIEW AVENUE NORTH STREET 2: SUITE 1200 CITY: SEATTLE STATE: WA ZIP: 98109 BUSINESS PHONE: 206-517-5300 MAIL ADDRESS: STREET 1: 400 FAIRVIEW AVENUE NORTH STREET 2: SUITE 1200 CITY: SEATTLE STATE: WA ZIP: 98109 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BYBEE CLINTON CENTRAL INDEX KEY: 0001219043 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37824 FILM NUMBER: 17634207 MAIL ADDRESS: STREET 1: 8755 W. HIGGINS ROAD STREET 2: SUITE 1025 CITY: CHICAGO STATE: IL ZIP: 60631 4 1 edgar.xml PRIMARY DOCUMENT X0306 4 2017-02-21 0001114995 IMPINJ INC PI 0001219043 BYBEE CLINTON C/O ARCH VENTURE PARTNERS 8755 WEST HIGGINS ROAD, SUITE 1025 CHICAGO IL 60631 1 0 0 0 Common Stock 2017-02-21 4 J 0 417 A 417 D Reflects shares received by the Reporting Person from a pro rata distribution by a venture capital limited partnership in which the Reporting Person holds a limited partner interest (and over which the Reporting Person does not exercise voting or investment control of its portfolio securities) for no consideration. /s/ Clinton Bybee 2017-02-23