0001209191-23-044092.txt : 20230801 0001209191-23-044092.hdr.sgml : 20230801 20230801205427 ACCESSION NUMBER: 0001209191-23-044092 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230801 FILED AS OF DATE: 20230801 DATE AS OF CHANGE: 20230801 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: 231133407 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 X0508 4 2023-08-01 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 0 Common Stock 2023-08-01 4 M 0 3000 0.84 A 246930 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 2023-08-01 4 M 0 3000 0.00 D 2030-05-10 Common Stock 3000 28132 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 2023-08-01