0001209191-21-057057.txt : 20210921 0001209191-21-057057.hdr.sgml : 20210921 20210921170459 ACCESSION NUMBER: 0001209191-21-057057 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210604 FILED AS OF DATE: 20210921 DATE AS OF CHANGE: 20210921 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HERSHBERG ROBERT CENTRAL INDEX KEY: 0001274139 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39756 FILM NUMBER: 211267103 MAIL ADDRESS: STREET 1: 3005 FIRST AVENUE CITY: SEATTLE STATE: WA ZIP: 98121 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 2021-06-04 0 0001671858 Silverback Therapeutics, Inc. SBTX 0001274139 HERSHBERG ROBERT C/O SILVERBACK THERAPEUTICS, INC. 500 FAIRVIEW AVENUE N, SUITE 600 SEATTLE WA 98109 1 0 0 0 Stock Option (right to buy) 28.83 2021-06-04 4 A 0 15000 0.00 A 2031-06-03 Common Stock 15000 15000 D The shares subject to the option vest on the earlier of June 4, 2022 or the date of the 2022 annual meeting of the Issuer's stockholders which date has not been set by the Issuer's Board of Directors. /s/ Jeffrey C. Pepe, Attorney-in-Fact 2021-09-21