1. Name and Address of Reporting Person*
601 UNION STREET, SUITE 3200 |
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(Street)
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2. Issuer Name and Ticker or Trading Symbol
ALPINE IMMUNE SCIENCES, INC.
[ ALPN ]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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Director |
X |
10% Owner |
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Officer (give title below) |
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Other (specify below) |
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3. Date of Earliest Transaction
(Month/Day/Year) 01/18/2019
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4. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Form filed by One Reporting Person |
X |
Form filed by More than One Reporting Person |
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1. Name and Address of Reporting Person*
601 UNION STREET, SUITE 3200 |
|
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
1. Name and Address of Reporting Person*
601 UNION STREET, SUITE 3200 |
|
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
1. Name and Address of Reporting Person*
601 UNION STREET, SUITE 3200 |
|
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
1. Name and Address of Reporting Person*
601 UNION STREET, SUITE 3200 |
|
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
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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 |
01/22/2019 |
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FHM Life Sciences VIII, L.P. By: FHM Life Sciences VIII, L.L.C., its general partner, By: /s/ Steve Bailey, Chief Financial Officer |
01/22/2019 |
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FHM Life Sciences VIII, L.L.C. By: /s/ Steve Bailey |
01/22/2019 |
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/s/ Steve Bailey, Attorney-in-Fact for Patrick J. Heron |
01/22/2019 |
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** Signature of Reporting Person |
Date |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
* If the form is filed by more than one reporting person,
see
Instruction
4
(b)(v). |
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure. |
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |