0001209191-23-031580.txt : 20230522
0001209191-23-031580.hdr.sgml : 20230522
20230522181138
ACCESSION NUMBER: 0001209191-23-031580
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20230519
FILED AS OF DATE: 20230522
DATE AS OF CHANGE: 20230522
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: 23945999
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: 453368487
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 18706 NORTH CREEK PARKWAY, SUITE 104
CITY: BOTHELL
STATE: WA
ZIP: 98011
BUSINESS PHONE: (425) 620-8501
MAIL ADDRESS:
STREET 1: 18706 NORTH CREEK PARKWAY, SUITE 104
CITY: BOTHELL
STATE: WA
ZIP: 98011
FORMER COMPANY:
FORMER CONFORMED NAME: M3 Biotechnology, Inc.
DATE OF NAME CHANGE: 20140924
4
1
doc4.xml
FORM 4 SUBMISSION
X0407
4
2023-05-19
0
0001620463
Athira Pharma, Inc.
ATHA
0001722055
Romano Kelly A
C/O ATHIRA PHARMA, INC.
18706 NORTH CREEK PARKWAY, SUITE 104
BOTHELL
WA
98011
1
0
0
0
0
Stock Option (Right to Buy)
2.89
2023-05-19
4
A
0
20900
0.00
A
2033-05-18
Common Stock
20900
20900
D
The shares subject to the option will vest on the earlier of (i) May 19, 2024, or (ii) the day immediately before the date of the next annual meeting of the Issuer's stockholders that occurs after May 19, 2023. The option reported was granted pursuant to the terms of the Issuer's Outside Director Compensation Policy.
/s/ Mark Worthington, Attorney in fact for Kelly A. Romano
2023-05-22
EX-24
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 Mark Worthington, Barbara Mery and
each of the responsible attorneys and paralegals of Wilson Sonsini Goodrich &
Rosati, Professional Corporation, the undersigned's true and lawful
attorney-in-fact 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 undersigned's ownership,
acquisition or disposition of securities of the Company; 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 undersigned's responsibilities 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 undersigned's holdings of and transactions in securities issued by the
Company, 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 May 18, 2023.
Signature: /s/ Kelly Romano
Kelly Romano