0001415889-24-011664.txt : 20240429 0001415889-24-011664.hdr.sgml : 20240429 20240429163208 ACCESSION NUMBER: 0001415889-24-011664 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240425 FILED AS OF DATE: 20240429 DATE AS OF CHANGE: 20240429 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Topper James N CENTRAL INDEX KEY: 0001341382 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37449 FILM NUMBER: 24891529 MAIL ADDRESS: STREET 1: 550 HAMILTON AVENUE, SUITE 100 CITY: PALO ALTO STATE: CA ZIP: 94301 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ALPINE IMMUNE SCIENCES, INC. CENTRAL INDEX KEY: 0001626199 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] ORGANIZATION NAME: 03 Life Sciences IRS NUMBER: 208969493 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 188 EAST BLAINE ST., SUITE 200 CITY: SEATTLE STATE: WA ZIP: 98102 BUSINESS PHONE: 206-788-4545 MAIL ADDRESS: STREET 1: 188 EAST BLAINE ST., SUITE 200 CITY: SEATTLE STATE: WA ZIP: 98102 FORMER COMPANY: FORMER CONFORMED NAME: Nivalis Therapeutics, Inc. DATE OF NAME CHANGE: 20150211 FORMER COMPANY: FORMER CONFORMED NAME: N30 Pharmaceuticals, Inc. DATE OF NAME CHANGE: 20141121 4 1 form4-04292024_080401.xml X0508 4 2024-04-25 0001626199 ALPINE IMMUNE SCIENCES, INC. ALPN 0001341382 Topper James N C/O FRAZIER LIFE SCIENCES 601 UNION STREET, SUITE 3200 SEATTLE WA 98101 true false false false 0 Common Stock 2024-04-25 4 X 0 1200000 0.001 A 2829366 I By: Frazier Life Sciences VIII, L.P. Common Stock 2024-04-25 4 S 0 19 64.57 D 2829347 I By: Frazier Life Sciences VIII, L.P. Warrant (Right to Buy) 0.001 2024-04-25 4 X 0 1200000 0 D Common Stock 1200000 0 I By: Frazier Life Sciences VIII, L.P. The reportable securities are held directly by Frazier Life Sciences VIII, L.P. ("FLS LP"). FHM Life Sciences VIII, L.P. ("FHM LP") is the general partner of FLS LP. FHM Life Sciences VIII, L.L.C. ("FHM LLC") is the general partner of FHM LP. James N. Topper is one of two managing members of FHM LLC. Dr. Topper disclaims beneficial ownership of the securities held by FLS LP except for his pecuniary interest therein, if any. On April 25, 2024, Frazier Life Sciences VIII, L.P. exercised a warrant to purchase 1,200,000 shares of the Issuer's Common Stock at an exercise price of $0.001 per share. Frazier Life Sciences VIII, L.P. paid the exercise price on a cashless basis, resulting in the Issuer withholding 19 shares of Common Stock to pay the exercise price and issuing Frazier Life Sciences VIII, L.P. the remaining 1,199,981 shares of Common Stock. The warrant had no expiration date and was exercisable immediately. /s/ Steve Bailey, Attorney-in-Fact for James N. Topper 2024-04-29