0001626199-22-000016.txt : 20220104
0001626199-22-000016.hdr.sgml : 20220104
20220104173702
ACCESSION NUMBER: 0001626199-22-000016
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: Venkatesan Jay
CENTRAL INDEX KEY: 0001413350
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37449
FILM NUMBER: 22507778
MAIL ADDRESS:
STREET 1: C/O AYER CAPITAL MANAGEMENT, LP
STREET 2: 230 CALIFORNIA ST, SUITE 600
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94111
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_164133579169890.xml
FORM 4
X0306
4
2022-01-03
0
0001626199
ALPINE IMMUNE SCIENCES, INC.
ALPN
0001413350
Venkatesan Jay
C/O ALPINE IMMUNE SCIENCES, INC.
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.
/s/ James Paul Rickey, attorney-in-fact
2022-01-04