0001209191-20-051057.txt : 20200917 0001209191-20-051057.hdr.sgml : 20200917 20200917202730 ACCESSION NUMBER: 0001209191-20-051057 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20200917 FILED AS OF DATE: 20200917 DATE AS OF CHANGE: 20200917 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KAWAS LEEN CENTRAL INDEX KEY: 0001822491 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39503 FILM NUMBER: 201182461 MAIL ADDRESS: STREET 1: 4000 MASON ROAD, SUITE 300 STREET 2: BOX 352141 CITY: SEATTLE STATE: WA ZIP: 98195-2141 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 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2020-09-17 0 0001620463 Athira Pharma, Inc. ATHA 0001822491 KAWAS LEEN C/O ATHIRA PHARMA, INC. 4000 MASON ROAD, SUITE 300 SEATTLE WA 98195 1 1 1 0 President & CEO Common Stock 1117246 D Common Stock 264810 I By Hamdan Family GST Trust Stock Option (Right to Buy) 0.16 2024-08-28 Common Stock 25220 D Stock Option (Right to Buy) 0.16 2024-08-28 Common Stock 50440 D Stock Option (Right to Buy) 0.48 2025-10-23 Common Stock 151320 D Stock Option (Right to Buy) 1.31 2023-01-21 Common Stock 63050 D Stock Option (Right to Buy) 1.49 2023-12-17 Common Stock 31525 D Stock Option (Right to Buy) 17.00 2030-09-16 Common Stock 209956 D Reflects a 7.9302-for-1 reverse stock split of the outstanding shares of the Issuer effected September 11, 2020. The shares subject to the option fully vested on January 20, 2016. The shares subject to the option fully vested on August 29, 2014. The shares subject to the option fully vested on October 24, 2017. The shares subject to the option fully vested on December 1, 2019. One-third of the shares subject to the option vested on January 1, 2020 and one-third of the shares subject to the option vest on each year thereafter. One-fourth of the shares subject to the option will vest on August 26, 2021 and one-fourth of the shares subject to the option vest on each year thereafter. Glenna Mileson, Attorney in fact for Leen Kawas 2020-09-17 EX-24.3_937718 2 poa.txt POA DOCUMENT POWER OF ATTORNEY The undersigned, as a Section 16 reporting person of Athira Pharma, Inc. (the Company), hereby constitutes and appoints Glenna Mileson, Barbara Mery and each of the responsible attorneys and paralegals of Wilson Sonsini Goodrich & Rosati, Professional Corporation, the undersigneds true and lawful attorney-in-fact to: 1. complete and execute Forms ID, 3,4 and 5 and other forms and all amendments thereto as such attorney-in-fact shall in his or her discretion determine to be required or advisable pursuant to Section 16 of the Securities Exchange Act of 1934 (as amended) and the rules and regulations promulgated thereunder, or any successor laws and regulations, as a consequence of the undersigneds ownership, acquisition or disposition of securities of the Company; and 2. do all acts necessary in order to file such forms with the Securities and Exchange Commission, any securities exchange or national association, the Company and such other person or agency as the attorney-in-fact shall deem appropriate. The undersigned hereby ratifies and confirms all that said attorneys-in-fact and agents shall do or cause to be done by virtue hereof. The undersigned acknowledges that the foregoing attorneys-in-fact, in serving in such capacity at the request of the undersigned, are not assuming, nor is the Company assuming, any of the undersigneds responsibilities to comply with Section 16 of the Securities Exchange Act of 1934 (as amended). This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms ID, 3, 4 and 5 with respect to the undersigneds holdings of and transactions in securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to the Company and the foregoing attorneys-in-fact. IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of August 28, 2020. . Signature: /s/ Leen Kawas Leen Kawas