0001209191-23-035458.txt : 20230608 0001209191-23-035458.hdr.sgml : 20230608 20230608164456 ACCESSION NUMBER: 0001209191-23-035458 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230606 FILED AS OF DATE: 20230608 DATE AS OF CHANGE: 20230608 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Veneman Ann M CENTRAL INDEX KEY: 0001493023 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40655 FILM NUMBER: 231002579 MAIL ADDRESS: STREET 1: C/O ICOSAVAX, INC. STREET 2: 1616 EASTLAKE AVENUE E. SUITE 208 CITY: SEATTLE STATE: WA ZIP: 98102 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Icosavax, Inc. CENTRAL INDEX KEY: 0001786255 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1930 BOREN AVE., SUITE 1000 CITY: SEATTLE STATE: WA ZIP: 98101 BUSINESS PHONE: (206) 737-0085 MAIL ADDRESS: STREET 1: 1930 BOREN AVE., SUITE 1000 CITY: SEATTLE STATE: WA ZIP: 98101 4 1 doc4.xml FORM 4 SUBMISSION X0407 4 2023-06-06 0 0001786255 Icosavax, Inc. ICVX 0001493023 Veneman Ann M C/O ICOSAVAX, INC. 1930 BOREN AVE., SUITE 1000 SEATTLE WA 98101 1 0 0 0 0 Stock Option (Right to Buy) 9.89 2023-06-06 4 A 0 17000 0.00 A 2033-06-05 Common Stock 17000 17000 D 1/12th of the total number of shares of common stock subject to the option vest monthly following June 6, 2023, the vesting commencement date, provided if the next occurring annual meeting of the Issuer's stockholders occurs prior to the full vesting of the option, any remaining options will vest on the date of such annual meeting, subject to the Reporting Person's continuous service on the board of directors of the Issuer through such vesting date. /s/ Elizabeth Bekiroglu, Attorney-in-Fact for Ann M. Veneman 2023-06-08