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