0001209191-22-005445.txt : 20220128 0001209191-22-005445.hdr.sgml : 20220128 20220128170140 ACCESSION NUMBER: 0001209191-22-005445 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220126 FILED AS OF DATE: 20220128 DATE AS OF CHANGE: 20220128 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ADAMS ADRIAN CENTRAL INDEX KEY: 0001248144 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40353 FILM NUMBER: 22569795 MAIL ADDRESS: STREET 1: C/O AUXILIUM PHARMACEUTICALS, INC. STREET 2: 640 LEE ROAD CITY: CHESTERBROOK STATE: PA ZIP: 19355 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 2022-01-26 0 0001445499 IMPEL NEUROPHARMA INC IMPL 0001248144 ADAMS ADRIAN C/O IMPEL NEUROPHARMA, INC. 201 ELLIOTT AVE. W, ST. 260 SEATTLE WA 98119 1 1 0 0 COB, CEO and President Stock Option (right to buy) 9.85 2022-01-26 4 A 0 175000 0.00 A 2032-01-25 Common Stock 175000 175000 D The option vests as to 2.0833% of the total shares on February 26, 2022 and then 2.0833% of the total shares vests monthly thereafter, with 100% of the total shares vested and exercisable on January 26, 2026, 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 2022-01-28