0001626199-24-000023.txt : 20240105 0001626199-24-000023.hdr.sgml : 20240105 20240105180728 ACCESSION NUMBER: 0001626199-24-000023 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240104 FILED AS OF DATE: 20240105 DATE AS OF CHANGE: 20240105 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Rickey James Paul CENTRAL INDEX KEY: 0001606243 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37449 FILM NUMBER: 24517776 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] 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 wk-form4_1704496038.xml FORM 4 X0508 4 2024-01-04 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 0 Common Stock 2024-01-04 4 A 0 31200 0 A 31200 D Stock Option (Right to buy) 18.33 2024-01-04 4 A 0 78000 0 A 2034-01-03 Common Stock 78000 78000 D Received grant of restricted stock units ("RSUs") for no consideration. One-fourth (1/4th) of the RSUs will vest on January 1, 2025 and the remainder will vest in twelve (12) equal quarterly installments on April 1, 2025 July 1, 2025, October 1, 2025 and on January 1, April 1, July 1, and October 1 of each subsequent year until all RSUs are vested on January 1, 2028, subject to the Reporting Person continuing to be a Service Provider through each such date. 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, 2025, 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, attorney-in-fact 2024-01-05