0001209191-22-041373.txt : 20220706 0001209191-22-041373.hdr.sgml : 20220706 20220706185311 ACCESSION NUMBER: 0001209191-22-041373 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220701 FILED AS OF DATE: 20220706 DATE AS OF CHANGE: 20220706 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Simpson Adam K. CENTRAL INDEX KEY: 0001873839 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40655 FILM NUMBER: 221070171 MAIL ADDRESS: STREET 1: C/O ICOSAVAX, INC. STREET 2: 1616 EASTLAKE AVENUE E., SUITE 208 CITY: SEATTLE STATE: WA ZIP: 98102 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Icosavax, Inc. CENTRAL INDEX KEY: 0001786255 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1616 EASTLAKE AVE E, SUITE 208 CITY: SEATTLE STATE: WA ZIP: 98102 BUSINESS PHONE: (206) 737-0085 MAIL ADDRESS: STREET 1: 1616 EASTLAKE AVE E, SUITE 208 CITY: SEATTLE STATE: WA ZIP: 98102 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2022-07-01 0 0001786255 Icosavax, Inc. ICVX 0001873839 Simpson Adam K. C/O ICOSAVAX, INC. 1930 BOREN AVE., SUITE 1000 SEATTLE WA 98101 1 1 0 0 Chief Executive Officer Common Stock 2022-07-01 4 M 0 7185 0.84 A 303245 D Common Stock 531576 I By family trust Common Stock 129032 I By family trust Common Stock 129032 I By family trust Stock Option (Right to Buy) 0.84 2022-07-01 4 M 0 7185 0.00 D 2030-05-10 Common Stock 7185 47896 D 25% of the shares subject to the option vested on 2/21/2021, and 1/48th of the shares subject to the option vest monthly thereafter. /s/ Elizabeth Bekiroglu, Attorney-in-Fact 2022-07-06