0001209191-20-062404.txt : 20201208 0001209191-20-062404.hdr.sgml : 20201208 20201208205643 ACCESSION NUMBER: 0001209191-20-062404 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201208 FILED AS OF DATE: 20201208 DATE AS OF CHANGE: 20201208 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CAPPS VICKIE L CENTRAL INDEX KEY: 0001248190 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39756 FILM NUMBER: 201376720 MAIL ADDRESS: STREET 1: 2985 SCOTT STREET CITY: VISTA STATE: CA ZIP: 92083 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Silverback Therapeutics, Inc. CENTRAL INDEX KEY: 0001671858 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 811489190 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 500 FAIRVIEW AVENUE NORTH, SUITE 600 CITY: SEATTLE STATE: WA ZIP: 98109 BUSINESS PHONE: 206-456-2900 MAIL ADDRESS: STREET 1: 500 FAIRVIEW AVENUE NORTH, SUITE 600 CITY: SEATTLE STATE: WA ZIP: 98109 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2020-12-08 0 0001671858 Silverback Therapeutics, Inc. SBTX 0001248190 CAPPS VICKIE L 500 FAIRVIEW AVENUE N, SUITE 600 SEATTLE WA 98109 1 0 0 0 Common Stock 2020-12-08 4 P 0 9523 21.00 A 61576 D The shares were purchased in the Issuer's initial public offering. /s/ Jeffrey C. Pepe, Attorney-in-Fact 2020-12-08