0001209191-23-058530.txt : 20231213 0001209191-23-058530.hdr.sgml : 20231213 20231213173053 ACCESSION NUMBER: 0001209191-23-058530 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231211 FILED AS OF DATE: 20231213 DATE AS OF CHANGE: 20231213 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Topper James N CENTRAL INDEX KEY: 0001341382 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37449 FILM NUMBER: 231485066 MAIL ADDRESS: STREET 1: 550 HAMILTON AVENUE, SUITE 100 CITY: PALO ALTO STATE: CA ZIP: 94301 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ALPINE IMMUNE SCIENCES, INC. CENTRAL INDEX KEY: 0001626199 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 208969493 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 188 EAST BLAINE ST., SUITE 200 CITY: SEATTLE STATE: WA ZIP: 98102 BUSINESS PHONE: 206-788-4545 MAIL ADDRESS: STREET 1: 188 EAST BLAINE ST., SUITE 200 CITY: SEATTLE STATE: WA ZIP: 98102 FORMER COMPANY: FORMER CONFORMED NAME: Nivalis Therapeutics, Inc. DATE OF NAME CHANGE: 20150211 FORMER COMPANY: FORMER CONFORMED NAME: N30 Pharmaceuticals, Inc. DATE OF NAME CHANGE: 20141121 4 1 doc4.xml FORM 4 SUBMISSION X0508 4 2023-12-11 0 0001626199 ALPINE IMMUNE SCIENCES, INC. ALPN 0001341382 Topper James N C/O FRAZIER HEALTHCARE PARTNERS 601 UNION STREET, SUITE 3200 SEATTLE WA 98101 1 0 0 0 0 Common Stock 2023-12-11 4 X 0 145251 12.74 A 1629366 I By: Frazier Life Sciences VIII, L.P. Warrant (Right to Buy) 12.74 2023-12-11 4 X 0 145251 0.00 D 2019-01-18 2024-01-18 Common Stock 145251 0 D The shares of Common Stock are held directly by Frazier Life Sciences VIII, L.P. ("FLS LP"). FHM Life Sciences VIII, L.P. ("FHM LP") is the general partner of FLS LP. FHM Life Sciences VIII, L.L.C. ("FHM LLC") is the general partner of FHM LP. James N. Topper is one of two managing members of FHM LLC. Dr. Topper disclaims beneficial ownership of the securities held by FLS LP except for his pecuniary interest therein, if any. /s/ Steve Bailey, Attorney-in-Fact for James N. Topper 2023-12-13