0001209191-22-061736.txt : 20221216 0001209191-22-061736.hdr.sgml : 20221216 20221216183656 ACCESSION NUMBER: 0001209191-22-061736 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20221215 FILED AS OF DATE: 20221216 DATE AS OF CHANGE: 20221216 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: 221469263 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 2022-12-15 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 Common Stock 2022-12-15 4 S 0 19648 11.1443 D 2792 I By Stanley Holtzman Common Stock 293258 D The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $11.08 to $11.26. The Reporting Person undertakes to provide the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote. Douglas Holtzman, Ph.D. holds power-of-attorney (POA) over the shares owned by Stanley Holtzman. As POA, Dr. Holtzman holds voting and dispositive control over such shares. Dr. Holtzman disclaims beneficial ownership of the shares over which he has POA except to the extent of any pecuniary interest therein. /s/ Elizabeth Bekiroglu, Attorney-in-Fact 2022-12-16