Delaware | 20-8969493 | |
(State or other jurisdiction of incorporation or organization) | (I.R.S. Employer Identification Number) |
Patrick J. Schultheis | ||
Michael Nordtvedt Bryan D. King | Paul Rickey | |
Wilson Sonsini Goodrich & Rosati, | Alpine Immune Sciences, Inc. | |
Professional Corporation | 188 East Blaine Street, Suite 200 | |
701 Fifth Avenue, Suite 5100 | Seattle, Washington 98102 | |
Seattle, Washington 98104-7036 | (206) 788-4545 | |
(206) 883-2500 |
Large accelerated filer | ¨ | Accelerated filer | ¨ | |
Non-accelerated filer | x | Smaller reporting company | x | |
Emerging growth company | x |
Title of Securities to be Registered | Amount to be Registered(1)(2) | Proposed Maximum Offering Price Per Share | Proposed Maximum Aggregate Offering Price | Amount of Registration Fee |
Common stock, $0.001 par value per share: | ||||
—Reserved for issuance under the 2018 Equity Incentive Plan | 929,394 | $2,24(3) | $2,081,843.00 | $271.00 |
TOTAL: | 929,394 | $2,081,843.00 | $271.00 | |
(1) | Pursuant to Rule 416(a) of the Securities Act of 1933, as amended (the “Securities Act”), this Registration Statement shall also cover any additional shares of the Registrant’s common stock that become issuable under the 2018 Equity Incentive Plan (the “2018 Plan”) by reason of any stock dividend, stock split, recapitalization or other similar transaction effected without receipt of consideration that increases the number of the Registrant’s outstanding shares of common stock. | |
(2) | Represents 929,394 additional shares of common stock reserved for issuance as a result of the annual evergreen increase pursuant to the 2018 Plan. | |
(3) | Estimated in accordance with Rules 457(c) and 457(h) of the Securities Act solely for purposes of calculating the registration fee on the basis of $2.24, the average of the high and low prices of the common stock, as reported on the Nasdaq Global Market on March 23, 2020. |
(1) | The Registrant’s Annual Report on Form 10-K for the fiscal year ended December 31, 2019, filed with the Commission on March 30, 2020; |
(2) | The Registrant's Current Report on Form 8-K filed with the Commission on January 27, 2020; and |
(3) | The description of the Registrant’s common stock contained in Exhibit 4.8 to the Registrant’s Annual Report on Form 10-K for the year ended December 31, 2019, filed with the Commission on March 30, 2020, and any amendment or report filed for the purpose of updating such description. |
Exhibit Number | Exhibit Description | Form | Incorporated by Reference | Filing Date | |||||||
File No. | Exhibit | ||||||||||
4.1 | 10-K | 001-37449 | 3.1 | March 28, 2018 | |||||||
4.2 | S-1 | 333-204127 | 3.4 | May 13, 2015 | |||||||
4.3 | 10-K | 001-37449 | 4.1 | March 28, 2018 | |||||||
4.4 | 8-K | 001-37449 | 10.1 | June 14, 2018 | |||||||
4.5 | 8-K | 001-37449 | 10.2 | June 14, 2018 | |||||||
4.6 | 8-K | 001-37449 | 10.1 | January 27, 2020 | |||||||
5.1+ | |||||||||||
23.1+ | |||||||||||
23.2+ | Consent of Wilson Sonsini Goodrich & Rosati, Professional Corporation (contained in Exhibit 5.1 hereto) | ||||||||||
24.1+ | Power of Attorney (contained on signature page hereto) |
+ | Filed herewith. |
Alpine Immune Sciences, Inc. | ||
By: | /s/ Mitchell H. Gold, M.D. | |
Mitchell H. Gold, M.D. | ||
Executive Chairman and Chief Executive Officer |
Signature | Title | Date | ||
/s/ Mitchell H. Gold, M.D. | Chief Executive Officer and Executive Chairman of the Board of Directors | March 30, 2020 | ||
Mitchell H. Gold, M.D. | (Principal Executive Officer) | |||
/s/ Paul Rickey | Senior Vice President and Chief Financial Officer | March 30, 2020 | ||
Paul Rickey | (Principal Accounting and Financial Officer) | |||
/s/ Jay Venkatesan, M.D. | Director | March 30, 2020 | ||
Jay Venkatesan, M.D. | ||||
/s/ James Topper, M.D., Ph.D. | Director | March 30, 2020 | ||
James Topper, M.D., Ph.D. | ||||
/s/ Robert Conway | Director | March 30, 2020 | ||
Robert Conway | ||||
/s/ Peter Thompson, M.D. | Director | March 30, 2020 | ||
Peter Thompson, M.D. | ||||
/s/ Paul Sekhri | Director | March 30, 2020 | ||
Paul Sekhri | ||||
/s/ Christopher Peetz | Director | March 30, 2020 | ||
Christopher Peetz | ||||
/s/ Min Cui, Ph.D. | Director | March 30, 2020 | ||
Min Cui, Ph.D. |
![]() | Wilson Sonsini Goodrich & Rosati Professional Corporation 701 Fifth Avenue Suite 5100 Seattle, Washington 98104-7036 O: 206.883.2500 F: 206.883.2699 |
Very truly yours, |
WILSON SONSINI GOODRICH & ROSATI |
Professional Corporation |
/s/ Wilson Sonsini Goodrich & Rosati, P.C. |
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