0001209191-20-063347.txt : 20201214
0001209191-20-063347.hdr.sgml : 20201214
20201214192411
ACCESSION NUMBER: 0001209191-20-063347
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20201211
FILED AS OF DATE: 20201214
DATE AS OF CHANGE: 20201214
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Romano Kelly A
CENTRAL INDEX KEY: 0001722055
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39503
FILM NUMBER: 201387774
MAIL ADDRESS:
STREET 1: C/O DORMAN PRODUCTS, INC.
STREET 2: 3400 EAST WALNUT STREET
CITY: COLMAR
STATE: PA
ZIP: 18915
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Athira Pharma, Inc.
CENTRAL INDEX KEY: 0001620463
STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 4000 MASON ROAD, SUITE 300
STREET 2: BOX 352141
CITY: SEATTLE
STATE: WA
ZIP: 981952141
BUSINESS PHONE: 5095927191
MAIL ADDRESS:
STREET 1: 4000 MASON ROAD, SUITE 300
STREET 2: BOX 352141
CITY: SEATTLE
STATE: WA
ZIP: 981952141
FORMER COMPANY:
FORMER CONFORMED NAME: M3 Biotechnology, Inc.
DATE OF NAME CHANGE: 20140924
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2020-12-11
0
0001620463
Athira Pharma, Inc.
ATHA
0001722055
Romano Kelly A
C/O ATHIRA PHARMA, INC.
4000 MASON ROAD, SUITE 300
SEATTLE
WA
98195
1
0
0
0
Stock Option (Right to Buy)
29.41
2020-12-11
4
A
0
27742
0.00
A
2030-12-10
Common Stock
27742
27742
D
One thirty-sixth of the shares subject to the option will vest on January 11, 2021 and one thirty-sixth of the shares subject to the option will vest
each month thereafter.
Glenna Mileson, Attorney in fact for Kelly A. Romano
2020-12-14
EX-24.4_950025
2
poa.txt
POA DOCUMENT
POWER OF ATTORNEY
The undersigned, as a Section 16 reporting person of Athira Pharma, Inc. (the
Company), hereby constitutes and appoints Glenna Mileson, Barbara Mery and each
of the responsible attorneys and paralegals of Wilson Sonsini Goodrich & Rosati,
Professional Corporation, the true and lawful attorney-in-fact of the
undersigned to:
1. complete and execute Forms ID, 3,4 and 5 and other forms and all amendments
thereto as such attorney-in-fact shall in his or her discretion determine to be
required or advisable pursuant to Section 16 of the Securities Exchange Act of
1934 (as amended) and the rules and regulations promulgated thereunder, or any
successor laws and regulations, as a consequence of the ownership, acquisition
or disposition of securities of the Company by the undersigned; and
2. do all acts necessary in order to file such forms with the Securities and
Exchange Commission, any securities exchange or national association, the
Company and such other person or agency as the attorney-in-fact shall deem
appropriate.
The undersigned hereby ratifies and confirms all that said attorneys-in-fact and
agents shall do or cause to be done by virtue hereof. The undersigned
acknowledges that the foregoing attorneys-in-fact, in serving in such capacity
at the request of the undersigned, are not assuming, nor is the Company
assuming, any of the responsibilities of the undersigned to comply with Section
16 of the Securities Exchange Act of 1934 (as amended).
This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms ID, 3, 4 and 5 with respect to
the holdings of and transactions in securities issued by the Company to the
undersigned, unless earlier revoked by the undersigned in a signed writing
delivered to the Company and the foregoing attorneys-in-fact.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of October 1, 2020. .
Signature: /s/ Kelly A. Romano