0001209191-24-002106.txt : 20240123
0001209191-24-002106.hdr.sgml : 20240123
20240123181519
ACCESSION NUMBER: 0001209191-24-002106
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240122
FILED AS OF DATE: 20240123
DATE AS OF CHANGE: 20240123
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Simpson Adam K.
CENTRAL INDEX KEY: 0001873839
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40655
FILM NUMBER: 24553792
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]
ORGANIZATION NAME: 03 Life Sciences
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
2024-01-22
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
2024-01-22
4
M
0
4789
0.84
A
265430
D
Common Stock
2024-01-22
4
M
0
93227
1.04
A
358657
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
2024-01-22
4
M
0
4789
0.00
D
2030-05-10
Common Stock
4789
0
D
Stock Option (Right to Buy)
1.04
2024-01-22
4
M
0
93227
0.00
D
2031-01-28
Common Stock
93227
206449
D
25% of the shares subject to the option vested on February 21, 2021, and 1/48th of the shares subject to the option vest monthly thereafter.
25% of the shares subject to the option vested on January 14, 2022, and 1/48th of the shares subject to the option vest monthly thereafter.
/s/ Elizabeth Bekiroglu, Attorney-in-Fact
2024-01-23