0001209191-23-029076.txt : 20230512 0001209191-23-029076.hdr.sgml : 20230512 20230512164142 ACCESSION NUMBER: 0001209191-23-029076 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230510 FILED AS OF DATE: 20230512 DATE AS OF CHANGE: 20230512 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Kalb Michael Wayne CENTRAL INDEX KEY: 0001678248 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40353 FILM NUMBER: 23916554 MAIL ADDRESS: STREET 1: 24 LUCILLE LANE CITY: DIX HILLS STATE: NY ZIP: 11746 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: IMPEL PHARMACEUTICALS INC CENTRAL INDEX KEY: 0001445499 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 263058238 STATE OF INCORPORATION: DE FISCAL YEAR END: 0426 BUSINESS ADDRESS: STREET 1: 201 ELLIOTT AVE. W STREET 2: SUITE 260 CITY: SEATTLE STATE: WA ZIP: 98119 BUSINESS PHONE: 206-568-1466 MAIL ADDRESS: STREET 1: 201 ELLIOTT AVE. W STREET 2: SUITE 260 CITY: SEATTLE STATE: WA ZIP: 98119 FORMER COMPANY: FORMER CONFORMED NAME: IMPEL NEUROPHARMA INC DATE OF NAME CHANGE: 20080917 4 1 doc4.xml FORM 4 SUBMISSION X0407 4 2023-05-10 0 0001445499 IMPEL PHARMACEUTICALS INC IMPL 0001678248 Kalb Michael Wayne C/O IMPEL PHARMACEUTICALS INC. 201 ELLIOTT AVE W, STE 260 SEATTLE WA 98119 0 1 0 0 CFO 0 Stock Option (right to buy) 2.43 2023-05-10 4 A 0 175000 0.00 A 2033-05-10 Common Stock 175000 175000 D Restricted Stock Units (RSUs) 2023-05-10 4 A 0 47500 0.00 A 2033-05-10 Common Stock 47500 47500 D The option vests as to 25% of the total shares on May 10, 2024 and then 1/48th of the total shares vests on each monthly anniversary thereafter, subject to the reporting person's provision of service to the issuer on each vesting date. Each RSU represents a contingent right to receive 1 share of the issuer's Common Stock upon settlement. The RSUs vest as to 100% of the total shares on May 31, 2024, subject to the reporting person's continuation of employment on such vesting date. /s/ Adrian Adams as attorney-in-fact 2023-05-12