0001626199-23-000022.txt : 20230105 0001626199-23-000022.hdr.sgml : 20230105 20230105190156 ACCESSION NUMBER: 0001626199-23-000022 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230104 FILED AS OF DATE: 20230105 DATE AS OF CHANGE: 20230105 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Rickey James Paul CENTRAL INDEX KEY: 0001606243 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37449 FILM NUMBER: 23513043 MAIL ADDRESS: STREET 1: ALPINE IMMUNE SCIENCES, INC. STREET 2: 188 EAST BLAINE STREET, SUITE 200 CITY: SEATTLE STATE: WA ZIP: 98102 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_167296329686813.xml FORM 4 X0306 4 2023-01-04 0 0001626199 ALPINE IMMUNE SCIENCES, INC. ALPN 0001606243 Rickey James Paul C/O ALPINE IMMUNE SCIENCES, INC. 188 EAST BLAINE STREET, SUITE 200 SEATTLE WA 98102 0 1 0 0 See Remarks Stock Option (Right to buy) 7.55 2023-01-04 4 A 0 109000 0 A 2033-01-03 Common Stock 109000.0 109000 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. One-fourth (1/4th) of the Shares subject to the Option will vest on January 4, 2024, and one thirty-sixth (1/36th) of the remaining Shares subject to the Option shall vest each month thereafter, subject to the Reporting Person continuing to be a service provider through each such date. Senior Vice President, Chief Financial Officer and Corporate Secretary /s/ James Paul Rickey 2023-01-05