0001209191-19-004783.txt : 20190122
0001209191-19-004783.hdr.sgml : 20190122
20190122171424
ACCESSION NUMBER: 0001209191-19-004783
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190118
FILED AS OF DATE: 20190122
DATE AS OF CHANGE: 20190122
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Frazier Life Sciences VIII, L.P.
CENTRAL INDEX KEY: 0001655827
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37449
FILM NUMBER: 19535958
BUSINESS ADDRESS:
STREET 1: 601 UNION STREET
STREET 2: SUITE 3200
CITY: SEATTLE
STATE: WA
ZIP: 98101
BUSINESS PHONE: 206-254-7200
MAIL ADDRESS:
STREET 1: 601 UNION STREET
STREET 2: SUITE 3200
CITY: SEATTLE
STATE: WA
ZIP: 98101
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: FHM LIFE SCIENCES VIII, L.P.
CENTRAL INDEX KEY: 0001698755
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37449
FILM NUMBER: 19535959
BUSINESS ADDRESS:
STREET 1: 601 UNION STREET
STREET 2: SUITE 3200
CITY: SEATTLE
STATE: WA
ZIP: 98101
BUSINESS PHONE: 206.621.7200
MAIL ADDRESS:
STREET 1: 601 UNION STREET
STREET 2: SUITE 3200
CITY: SEATTLE
STATE: WA
ZIP: 98101
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: FHM LIFE SCIENCES VIII, L.L.C.
CENTRAL INDEX KEY: 0001698823
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37449
FILM NUMBER: 19535960
BUSINESS ADDRESS:
STREET 1: 601 UNION STREET
STREET 2: SUITE 3200
CITY: SEATTLE
STATE: WA
ZIP: 98101
BUSINESS PHONE: 206.621.7200
MAIL ADDRESS:
STREET 1: 601 UNION STREET
STREET 2: SUITE 3200
CITY: SEATTLE
STATE: WA
ZIP: 98101
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Heron Patrick J
CENTRAL INDEX KEY: 0001365617
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37449
FILM NUMBER: 19535961
MAIL ADDRESS:
STREET 1: 550 HAMILTON AVE., 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: 201 ELLIOTT AVE. WEST, SUITE 230
CITY: SEATTLE
STATE: WA
ZIP: 98119
BUSINESS PHONE: 206-788-4545
MAIL ADDRESS:
STREET 1: 201 ELLIOTT AVE. WEST, SUITE 230
CITY: SEATTLE
STATE: WA
ZIP: 98119
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
X0306
4
2019-01-18
0
0001626199
ALPINE IMMUNE SCIENCES, INC.
ALPN
0001655827
Frazier Life Sciences VIII, L.P.
601 UNION STREET, SUITE 3200
SEATTLE
WA
98101
0
0
1
0
0001698755
FHM LIFE SCIENCES VIII, L.P.
601 UNION STREET, SUITE 3200
SEATTLE
WA
98101
0
0
1
0
0001698823
FHM LIFE SCIENCES VIII, L.L.C.
601 UNION STREET, SUITE 3200
SEATTLE
WA
98101
0
0
1
0
0001365617
Heron Patrick J
601 UNION STREET, SUITE 3200
SEATTLE
WA
98101
0
0
1
0
Common Stock
2019-01-18
4
P
0
372439
5.37
A
2571450
D
Warrant (Right to Buy)
12.74
2019-01-18
4
P
0
145251
0.00
A
2019-01-18
2024-01-18
Common Stock
145251
145251
D
The reportable securities 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 Topper and Patrick Heron are the sole managing members of FHM LLC. Mr. Heron, FHM LP and FHM LLC disclaims beneficial ownership of the securities held by FLS LP except, to the extent of his or its pecuniary interest therein, if any.
Frazier Life Sciences VIII, L.P. By: FHM Life Sciences VIII, L.P., its general partner, By FHM Life Sciences VIII, L.L.C., its general partner, By: /s/ Steve Bailey, Chief Financial Officer
2019-01-22
FHM Life Sciences VIII, L.P. By: FHM Life Sciences VIII, L.L.C., its general partner, By: /s/ Steve Bailey, Chief Financial Officer
2019-01-22
FHM Life Sciences VIII, L.L.C. By: /s/ Steve Bailey
2019-01-22
/s/ Steve Bailey, Attorney-in-Fact for Patrick J. Heron
2019-01-22