0001209191-21-026722.txt : 20210414 0001209191-21-026722.hdr.sgml : 20210414 20210414185016 ACCESSION NUMBER: 0001209191-21-026722 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210412 FILED AS OF DATE: 20210414 DATE AS OF CHANGE: 20210414 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DOSSETT JEFFREY CENTRAL INDEX KEY: 0001578147 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37824 FILM NUMBER: 21826888 MAIL ADDRESS: STREET 1: 400 FAIRVIEW AVE. N STREET 2: SUITE 1200 CITY: SEATTLE STATE: WA ZIP: 98109 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: IMPINJ INC CENTRAL INDEX KEY: 0001114995 STANDARD INDUSTRIAL CLASSIFICATION: ELECTRONIC COMPONENTS, NEC [3679] IRS NUMBER: 912041398 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 400 FAIRVIEW AVENUE NORTH STREET 2: SUITE 1200 CITY: SEATTLE STATE: WA ZIP: 98109 BUSINESS PHONE: 206-517-5300 MAIL ADDRESS: STREET 1: 400 FAIRVIEW AVENUE NORTH STREET 2: SUITE 1200 CITY: SEATTLE STATE: WA ZIP: 98109 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-04-12 0 0001114995 IMPINJ INC PI 0001578147 DOSSETT JEFFREY 400 FAIRVIEW AVE N. SUITE 1200 SEATTLE WA 98109 0 1 0 0 Chief Revenue Officer Restricted Stock Units 0.00 2021-04-12 4 A 0 20000 0.00 A Common Stock 20000 20000 D Each restricted stock unit represents a contingent right to receive one share of Impinj common stock. One-fourth of the shares subject to the grant shall vest on April 13, 2022, and 1/16th of the shares subject to the grant shall vest each quarter thereafter, subject to the Reporting Person's continued service to the Issuer through such date. /s/ Yukio Morikubo, Attorney in fact for Jeffrey Dossett 2021-04-14