0001209191-21-046564.txt : 20210713 0001209191-21-046564.hdr.sgml : 20210713 20210713170636 ACCESSION NUMBER: 0001209191-21-046564 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210711 FILED AS OF DATE: 20210713 DATE AS OF CHANGE: 20210713 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: NELSON TIMOTHY S CENTRAL INDEX KEY: 0001244229 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40353 FILM NUMBER: 211088556 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 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-07-11 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) 9.96 2021-07-11 4 A 0 11500 0.00 A 2031-07-10 Common Stock 11500 11500 D The option is 100% vested on July 11, 2022. /s/ John Leaman, M.D. as attorney-in-fact 2021-07-13