0001626199-23-000099.txt : 20231004
0001626199-23-000099.hdr.sgml : 20231004
20231004171413
ACCESSION NUMBER: 0001626199-23-000099
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20231002
FILED AS OF DATE: 20231004
DATE AS OF CHANGE: 20231004
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Dummer Wolfgang
CENTRAL INDEX KEY: 0001749991
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37449
FILM NUMBER: 231308879
MAIL ADDRESS:
STREET 1: 5491 OPTICAL CT.
CITY: SAN JOSE
STATE: CA
ZIP: 95138
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_1696454044.xml
FORM 4
X0508
4
2023-10-02
0
0001626199
ALPINE IMMUNE SCIENCES, INC.
ALPN
0001749991
Dummer Wolfgang
C/O ALPINE IMMUNE SCIENCES, INC.
188 EAST BLAINE STREET, SUITE 200
SEATTLE
WA
98102
0
1
0
0
Chief Medical Officer
0
Stock Option (Right to buy)
11.37
2023-10-02
4
A
0
200000
0
A
2033-10-01
Common Stock
200000
200000
D
One-fourth (1/4) of the shares subject to the option will vest on October 2, 2024, and one thirty-sixth (1/36th) of the remaining shares subject to the option shall vest each month thereafter, subject to
Reporting Person continuing to be a service provider through each such date.
/s/ James Paul Rickey
2023-10-04