0001209191-22-056826.txt : 20221114
0001209191-22-056826.hdr.sgml : 20221114
20221114185801
ACCESSION NUMBER: 0001209191-22-056826
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20221110
FILED AS OF DATE: 20221114
DATE AS OF CHANGE: 20221114
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Holtzman Douglas
CENTRAL INDEX KEY: 0001874371
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40655
FILM NUMBER: 221388564
MAIL ADDRESS:
STREET 1: 1616 EASTLAKE AVENUE E.
STREET 2: 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: 1930 BOREN AVE., SUITE 1000
CITY: SEATTLE
STATE: WA
ZIP: 98101
BUSINESS PHONE: (206) 737-0085
MAIL ADDRESS:
STREET 1: 1930 BOREN AVE., SUITE 1000
CITY: SEATTLE
STATE: WA
ZIP: 98101
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2022-11-10
0
0001786255
Icosavax, Inc.
ICVX
0001874371
Holtzman Douglas
C/O ICOSAVAX, INC.
1930 BOREN AVE., SUITE 1000
SEATTLE
WA
98101
0
1
0
0
Chief Scientific Officer
Stock Option (Right to Buy)
2.47
2022-11-10
4
A
0
82580
0.00
A
2032-11-09
Common Stock
82580
82580
D
One-third (1/3rd) of the shares subject to the option shall vest on each of the first three anniversaries of November 10, 2022, subject to the reporting person's continued service through the applicable vesting date.
/s/ Elizabeth Bekiroglu, Attorney-in-Fact
2022-11-14