0001626199-22-000006.txt : 20220104
0001626199-22-000006.hdr.sgml : 20220104
20220104171951
ACCESSION NUMBER: 0001626199-22-000006
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220103
FILED AS OF DATE: 20220104
DATE AS OF CHANGE: 20220104
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Thompson Peter A.
CENTRAL INDEX KEY: 0001357522
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37449
FILM NUMBER: 22507493
MAIL ADDRESS:
STREET 1: C/O ANTHERA PHARMACEUTICALS, INC.
STREET 2: 25801 INDUSTRIAL BOULEVARD, SUITE B
CITY: HAYWARD
STATE: CA
ZIP: 94545
FORMER NAME:
FORMER CONFORMED NAME: Thompson Peter A
DATE OF NAME CHANGE: 20060327
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
wf-form4_164133476170143.xml
FORM 4
X0306
4
2022-01-03
0
0001626199
ALPINE IMMUNE SCIENCES, INC.
ALPN
0001357522
Thompson Peter A.
C/O ALPINE IMMUNE SCIENCES, INC. (ALPN)
188 EAST BLAINE STREET, SUITE 200
SEATTLE
WA
98102
1
0
1
0
Stock Option (Right to buy)
13.89
2022-01-03
4
A
0
10000
0
A
2032-01-02
Common Stock
10000.0
10000
D
The exercise price is equal to the closing price per share of Common Stock as reported on the Nasdaq Global Market on the date of grant.
1/12th of the shares subject to the option become vested and exercisable on February 3, 2022 and 1/12th of the shares subject to the option shall vest monthly thereafter.
The Reporting Person is a member of OrbiMed Advisors LLC ("OrbiMed Advisors"). Pursuant to an agreement with OrbiMed Advisors, the Reporting Person is obligated to transfer these securities, or the economic benefit thereof, to OrbiMed Advisors and OrbiMed Capital GP VI LLC, which will in turn ensure that such securities or economic benefits are provided to OrbiMed Private Investments VI, LP.
/s/ James Paul Rickey, attorney-in-fact
2022-01-04