0001209191-22-037961.txt : 20220617 0001209191-22-037961.hdr.sgml : 20220617 20220617170656 ACCESSION NUMBER: 0001209191-22-037961 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220616 FILED AS OF DATE: 20220617 DATE AS OF CHANGE: 20220617 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Wilfong Diane E. CENTRAL INDEX KEY: 0001374988 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40353 FILM NUMBER: 221024887 MAIL ADDRESS: STREET 1: 333 LAKESIDE DRIVE CITY: FOSTER CITY STATE: CA ZIP: 94404 FORMER NAME: FORMER CONFORMED NAME: Wilfong Diane E DATE OF NAME CHANGE: 20060907 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: IMPEL PHARMACEUTICALS INC CENTRAL INDEX KEY: 0001445499 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 263058238 STATE OF INCORPORATION: DE FISCAL YEAR END: 0426 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 FORMER COMPANY: FORMER CONFORMED NAME: IMPEL NEUROPHARMA INC DATE OF NAME CHANGE: 20080917 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2022-06-16 0 0001445499 IMPEL PHARMACEUTICALS INC IMPL 0001374988 Wilfong Diane E. C/O IMPEL PHARMACEUTICALS INC. 201 ELLIOTT AVE. W, ST. 260 SEATTLE WA 98119 1 0 0 0 Stock Option (right to buy) 8.65 2022-06-16 4 A 0 12789 0.00 A 2032-06-15 Common Stock 12789 12789 D The option is 100% vested on June 16, 2023. /s/ John Leaman, M.D. as attorney-in-fact 2022-06-17