0001209191-23-035454.txt : 20230608
0001209191-23-035454.hdr.sgml : 20230608
20230608164241
ACCESSION NUMBER: 0001209191-23-035454
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230606
FILED AS OF DATE: 20230608
DATE AS OF CHANGE: 20230608
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Shiver John W.
CENTRAL INDEX KEY: 0001900372
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40655
FILM NUMBER: 231002551
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: 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
X0407
4
2023-06-06
0
0001786255
Icosavax, Inc.
ICVX
0001900372
Shiver John W.
C/O ICOSAVAX, INC.
1930 BOREN AVE., SUITE 1000
SEATTLE
WA
98101
1
0
0
0
0
Stock Option (Right to Buy)
9.89
2023-06-06
4
A
0
17000
0.00
A
2033-06-05
Common Stock
17000
17000
D
1/12th of the total number of shares of common stock subject to the option vest monthly following June 6, 2023, the vesting commencement date, provided if the next occurring annual meeting of the Issuer's stockholders occurs prior to the full vesting of the option, any remaining options will vest on the date of such annual meeting, subject to the Reporting Person's continuous service on the board of directors of the Issuer through such vesting date.
/s/ Elizabeth Bekiroglu, Attorney-in-Fact for John W. Shiver
2023-06-08