0001209191-20-051512.txt : 20200922
0001209191-20-051512.hdr.sgml : 20200922
20200922171651
ACCESSION NUMBER: 0001209191-20-051512
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200922
FILED AS OF DATE: 20200922
DATE AS OF CHANGE: 20200922
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: FLUKE JOHN M JR
CENTRAL INDEX KEY: 0001191906
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39503
FILM NUMBER: 201190249
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Athira Pharma, Inc.
CENTRAL INDEX KEY: 0001620463
STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 4000 MASON ROAD, SUITE 300
STREET 2: BOX 352141
CITY: SEATTLE
STATE: WA
ZIP: 981952141
BUSINESS PHONE: 5095927191
MAIL ADDRESS:
STREET 1: 4000 MASON ROAD, SUITE 300
STREET 2: BOX 352141
CITY: SEATTLE
STATE: WA
ZIP: 981952141
FORMER COMPANY:
FORMER CONFORMED NAME: M3 Biotechnology, Inc.
DATE OF NAME CHANGE: 20140924
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2020-09-22
0
0001620463
Athira Pharma, Inc.
ATHA
0001191906
FLUKE JOHN M JR
C/O ATHIRA PHARMA, INC.
4000 MASON ROAD, SUITE 300
SEATTLE
WA
98195
1
0
0
0
Common Stock
2020-09-22
4
C
0
12610
0.00
A
63050
D
Common Stock
2020-09-22
4
C
0
51831
0.00
A
114881
D
Common Stock
2020-09-22
4
C
0
6731
0.00
A
6731
I
By Fluke Capital Management, L.P.
Series A Preferred Stock
2020-09-22
4
C
0
12610
0.00
D
Common Stock
12610
0
D
Series A-1 Preferred Stock
2020-09-22
4
C
0
51831
0.00
D
Common Stock
51831
0
D
Series B-1 Preferred Stock
2020-09-22
4
C
0
6731
0.00
D
Common Stock
6731
0
I
By Fluke Capital Management, L.P.
Each share of Series A Preferred Stock automatically converted into one share of Common Stock immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.
Each share of Series A-1 Preferred Stock automatically converted into one share of Common Stock immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.
Each share of Series B-1 Preferred Stock automatically converted into one share of Common Stock immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.
/s/ Glenna Mileson, attorney-in-fact on behalf of John M. Fluke, Jr.
2020-09-22