0001209191-21-028007.txt : 20210422
0001209191-21-028007.hdr.sgml : 20210422
20210422191012
ACCESSION NUMBER: 0001209191-21-028007
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20210422
FILED AS OF DATE: 20210422
DATE AS OF CHANGE: 20210422
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: NELSON TIMOTHY S
CENTRAL INDEX KEY: 0001244229
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40353
FILM NUMBER: 21846226
MAIL ADDRESS:
STREET 1: 1024 BUBB ROAD
CITY: CUPERTINO
STATE: CA
ZIP: 950144166
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: IMPEL NEUROPHARMA INC
CENTRAL INDEX KEY: 0001445499
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 263058238
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 201 ELLIOTT AVE. W
STREET 2: SUITE 260
CITY: SEATTLE
STATE: WA
ZIP: 98119
BUSINESS PHONE: 206-568-1466
MAIL ADDRESS:
STREET 1: 201 ELLIOTT AVE. W
STREET 2: SUITE 260
CITY: SEATTLE
STATE: WA
ZIP: 98119
3
1
doc3.xml
FORM 3 SUBMISSION
X0206
3
2021-04-22
0
0001445499
IMPEL NEUROPHARMA INC
IMPL
0001244229
NELSON TIMOTHY S
C/O IMPEL NEUROPHARMA, INC.
201 ELLIOTT AVE. W, ST. 260
SEATTLE
WA
98119
1
0
0
0
Stock Option (right to buy)
1.96
2027-02-13
Common Stock
12303
D
Stock Option (right to buy)
1.96
2027-02-13
Common Stock
61516
D
Stock Option (right to buy)
2.46
2028-03-08
Common Stock
3053
D
Stock Option (right to buy)
2.95
2029-02-07
Common Stock
22325
D
The option is 100% vested and exercisable.
The option vested as to 25% of the total shares on February 13, 2019, then 2.0833% of the total shares vest monthly thereafter, with 100% of the total shares vested and exercisable on February 13, 2022, subject to the reporting person's provision of service to the issuer on each vesting date.
The option vested as to 25% of the total shares on February 8, 2020, then 2.0833% of the total shares vest monthly thereafter, with 100% of the total shares vested and exercisable on February 8, 2023, subject to the reporting person's provision of service to the issuer on each vesting date.
/s/ John Leaman, M.D. as attorney-in-fact
2021-04-22
EX-24.3_980509
2
poa.txt
POA DOCUMENT
POWER OF ATTORNEY
KNOW ALL BY THESE PRESENTS, that the undersigned hereby constitutes and appoints
Adrian Adams, John Leaman, M.D. and John Hoekman, Ph.D., and each of them,
his/her true and lawful attorney-in-fact to:
(1) execute for and on behalf of the undersigned, in the undersigned's capacity
as a representative of Impel NeuroPharma, Inc. (the "Company"), any and all Form
3, 4 or 5 reports required to be filed by the undersigned in accordance with
Section 16(a) of the Securities Exchange Act of 1934, as amended (the "Exchange
Act"), and the rules thereunder with respect to transactions in securities of
the Company;
(2) do and perform any and all acts for and on behalf of the undersigned which
may be necessary or desirable to complete and execute any such Form 3, 4 or 5
report and timely file such report with the U.S. Securities and Exchange
Commission and any stock exchange or similar authority; and
(3) take any other action of any type whatsoever in connection with the
foregoing which, in the opinion of such attorney in-fact, may be of benefit to,
in the best interest of, or legally required by, the undersigned, it being
understood that the documents executed by such attorney-in-fact on behalf of the
undersigned, pursuant to this Power of Attorney, shall be in such form and shall
contain such terms and conditions as such attorney-in-fact may approve in
her/his discretion.
The undersigned hereby grants to each such attorney-in-fact full power and
authority to do and perform each and every act and thing whatsoever requisite,
necessary and proper to be done in the exercise of any of the rights and powers
herein granted, as fully to all intents and purposes as the undersigned might or
could do if personally present, with full power of substitution or revocation,
hereby ratifying and confirming all that such attorney-in-fact, or her/his
substitute or substitutes, shall lawfully do or cause to be done by virtue of
this Power of Attorney and the rights and powers herein granted. The
undersigned acknowledges that no such attorney-in-fact, in serving in such
capacity at the request of the undersigned, is hereby assuming, nor is the
Company hereby assuming, any of the undersigned's responsibilities to comply
with Section 16 of the Exchange Act.
This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Form 3, 4 or 5 reports with respect to
the undersigned's holdings of and transactions in securities issued by the
Company, unless earlier revoked by the undersigned in a signed writing delivered
to the foregoing attorneys-in-fact.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of 3/16/2021.
/s/ Timothy Nelson
Timothy Nelson