0001246360-19-001376.txt : 20190507
0001246360-19-001376.hdr.sgml : 20190507
20190507182111
ACCESSION NUMBER: 0001246360-19-001376
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190503
FILED AS OF DATE: 20190507
DATE AS OF CHANGE: 20190507
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: ALBERG TOM A
CENTRAL INDEX KEY: 0001184752
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37824
FILM NUMBER: 19804548
MAIL ADDRESS:
STREET 1: PO BOX 81226
CITY: SEATTLE
STATE: WA
ZIP: 98108-1226
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
form.xml
PRIMARY DOCUMENT
X0306
4
2019-05-03
false
0001114995
IMPINJ INC
PI
0001184752
ALBERG TOM A
400 FAIRVIEW AVE N. SUITE 1200
SEATTLE
WA
98109
true
false
false
false
COMMON STOCK
31219
I
By Raven Trust Fund
COMMON STOCK
2019-05-03
4
J
false
1718
0
A
114510
D
Shares held of record by Raven Trust Fund. Mr. Alberg shares voting and dispositive control over such shares but disclaims beneficial ownership over such shares.
Pro rata distribution of Common Stock held by ARCH Venture Fund V, L.P. and ARCH V Entrepreneurs Fund, L.P. to its partners for no consideration.
Yukio Morikubo as Attorney in fact for Tom Alberg
2019-05-07