0001209191-24-002014.txt : 20240122 0001209191-24-002014.hdr.sgml : 20240122 20240122174823 ACCESSION NUMBER: 0001209191-24-002014 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240118 FILED AS OF DATE: 20240122 DATE AS OF CHANGE: 20240122 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Cui Xiangmin CENTRAL INDEX KEY: 0001487815 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37449 FILM NUMBER: 24550031 MAIL ADDRESS: STREET 1: NO. 14 EAST HUSHAN ROAD STREET 2: TAI'AN CITY CITY: SHANDONG STATE: F4 ZIP: 000000 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ALPINE IMMUNE SCIENCES, INC. CENTRAL INDEX KEY: 0001626199 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] ORGANIZATION NAME: 03 Life Sciences 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 doc4.xml FORM 4 SUBMISSION X0508 4 2024-01-18 0 0001626199 ALPINE IMMUNE SCIENCES, INC. ALPN 0001487815 Cui Xiangmin C/O ALPINE IMMUNE SCIENCES, INC. 201 ELLIOT AVENUE WEST, SUITE 230 SEATTLE WA 98119 1 0 1 0 0 Common Stock 2024-01-18 4 X 0 1234636 12.74 A 6582380 I See Footnote Common Stock 1735544 I See Footnote Warrant (right to buy) 12.74 2024-01-18 4 X 0 1234636 0.00 D 2019-01-18 2024-01-18 Common Stock 1234636 0 I See Footnote These securities are owned directly by Decheng Capital China Life Sciences USD Fund III, L.P. ("Fund III"). The Reporting Person is the manager of Decheng Capital Management III (Cayman), LLC, the general partner of Fund III. The Reporting Person disclaims beneficial ownership of these securities, except to the extent of his pecuniary interest therein. These securities are owned directly by Decheng Capital Global Healthcare Fund (Master), LP ("Healthcare"). The Reporting Person is the indirect managing member and ultimate beneficial owner of Decheng Capital Global Healthcare GP, LLC, the general partner of Healthcare. The Reporting Person disclaims beneficial ownership of these securities, except to the extent of his pecuniary interest therein. /s/ Xiangmin Cui 2024-01-22