0001209191-22-049199.txt : 20220908 0001209191-22-049199.hdr.sgml : 20220908 20220908170448 ACCESSION NUMBER: 0001209191-22-049199 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20220902 FILED AS OF DATE: 20220908 DATE AS OF CHANGE: 20220908 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Pepe Jeffrey C. CENTRAL INDEX KEY: 0001943992 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39756 FILM NUMBER: 221234403 MAIL ADDRESS: STREET 1: C/O SILVERBACK THERAPEUTICS, INC. STREET 2: 500 FAIRVIEW AVENUE N, SUITE 600 CITY: SEATTLE STATE: WA ZIP: 98109 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Silverback Therapeutics, Inc. CENTRAL INDEX KEY: 0001671858 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 811489190 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 500 FAIRVIEW AVENUE NORTH, SUITE 600 CITY: SEATTLE STATE: WA ZIP: 98109 BUSINESS PHONE: 206-456-2900 MAIL ADDRESS: STREET 1: 500 FAIRVIEW AVENUE NORTH, SUITE 600 CITY: SEATTLE STATE: WA ZIP: 98109 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2022-09-02 0 0001671858 Silverback Therapeutics, Inc. SBTX 0001943992 Pepe Jeffrey C. C/O SILVERBACK THERAPEUTICS, INC. 500 FAIRVIEW AVENUE N, SUITE 600 SEATTLE WA 98109 0 1 0 0 Interim CEO and GC Common Stock 52323 D Stock option (right to buy) 1.68 2029-09-10 Common Stock 35407 D Stock option (right to buy) 1.27 2030-04-28 Common Stock 22401 D Stock option (right to buy) 1.27 2030-04-28 Common Stock 17619 D Stock option (right to buy) 1.27 2030-04-28 Common Stock 18268 D Stock option (right to buy) 6.65 2030-09-30 Common Stock 26932 D Stock option (right to buy) 21.00 2030-12-02 Common Stock 102039 D Stock option (right to buy) 4.85 2032-01-31 Common Stock 45000 D Stock option (right to buy) 4.85 2032-01-31 Common Stock 28500 D Stock option (right to buy) 3.15 2032-05-01 Common Stock 79261 D 25% of the shares subject to the option vested on August 19, 2020, and the remaining shares will vest monthly thereafter over three years. 25% of the shares subject to the option vested on March 4, 2021, and the remaining shares will vest monthly thereafter over three years. 25% of the shares subject to the option vested on July 1, 2021, and the remaining shares will vest monthly thereafter over three years. The shares subject to the option will vest in equal monthly installments over the 48 months beginning on October 18, 2020. The shares subject to the option will vest in equal monthly installments over the 48 months beginning on October 22, 2020. The shares subject to the option will vest in equal monthly installments over the 48 months beginning on January 3, 2021. The shares subject to the option will vest in equal monthly installments over the 48 months beginning on March 1, 2022. 25% of the shares subject to the option will vest on February 1, 2023, and the remaining shares will vest monthly thereafter over three years. The shares subject to the option will vest on May 2, 2023. /s/ Jeffrey C. Pepe 2022-09-07 EX-24 2 poa.txt POA DOCUMENT LIMITED POWER OF ATTORNEY FOR SECTION 16(a) FILINGS Know all by these presents, that the undersigned hereby constitutes and appoints each of Andrew Alwood and Jonathan Piazza, signing individually, as the undersigned's true and lawful attorney-in fact to: (1) Execute for and on behalf of the undersigned, in the undersigned's capacity as an officer, director and/or stockholder of Silverback Therapeutics, Inc. (the "Company"), Forms 3, 4, and 5 and amendments thereto in accordance with Section 16(a) of the Securities Exchange Act of 1934, as amended (the "Exchange Act") and the rules thereunder; (2) Do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Form 3, 4, or 5, or amendment thereto and timely file such form with the United States Securities and Exchange Commission (the "SEC") and any stock exchange or similar authority; and (3) Take any other action of any type whatsoever which, in the opinion of any such attorney-in-fact, may be necessary or desirable in connection with the foregoing authority, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Limited Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-facts discretion. The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever required, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this Limited Power of Attorney and the rights and powers herein granted. The undersigned acknowledges that each of the foregoing attorneys-in-fact, in serving in such capacity at the request of the undersigned, is not assuming, nor is the Company assuming, any of the undersigned's responsibilities to comply with Section 16 of the Exchange Act. This Limited Power of Attorney shall remain in full force and effect until the earlier to occur of (a) undersigned is no longer required to file Forms 3, 4 and 5 with respect to any securities issued by the Company, (b) revocation by the undersigned in a signed writing delivered to the foregoing attorney-in-fact and (c) as to any attorney in fact individually until such attorney-in-fact is no longer employed by the Company. This Limited Power of Attorney may be filed with the SEC as a confirming statement of the authority granted herein. IN WITNESS WHEREOF, the undersigned has caused this Limited Power of Attorney to be executed as of August 22, 2022. /s/ Jeffrey C. Pepe, Ph.D., J.D.