0001626199-23-000119.txt : 20231108 0001626199-23-000119.hdr.sgml : 20231108 20231108172054 ACCESSION NUMBER: 0001626199-23-000119 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231106 FILED AS OF DATE: 20231108 DATE AS OF CHANGE: 20231108 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: 231389302 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 wk-form4_1699482039.xml FORM 4 X0508 4 2023-11-06 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 1 Common Stock 2023-11-06 4 M 0 10989 3.23 A 18003 D Common Stock 2023-11-06 4 S 0 18003 16.0281 D 0 D Stock Option (Right to buy) 3.23 2023-11-06 4 M 0 10989 0 D 2030-01-22 Common Stock 10989 91011 D The transactions reported in this Form 4 were effected pursuant to a Rule 10b5-1 trading plan adopted by the reporting person on June 12, 2023. This transaction was executed in multiple trades at prices ranging from $16.00 to $16.19. The price reported above reflects the weighted average sale price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected. Twenty-five percent (25%) of the shares subject to the Option shall vest on the one (1) year anniversary of January 23, 2020 (the "Vesting Commencement Date") and one forty-eighth (1/48th) of the shares subject to the Option shall vest each month thereafter on the same day of the month as the Vesting Commencement Date (and if there is no corresponding day, on the last day of the month), subject to the Reporting Person continuing to be a Service Provider through each such date. /s/ James Paul Rickey 2023-11-08