0001626199-24-000012.txt : 20240104 0001626199-24-000012.hdr.sgml : 20240104 20240104190544 ACCESSION NUMBER: 0001626199-24-000012 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240102 FILED AS OF DATE: 20240104 DATE AS OF CHANGE: 20240104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Drappa Jorn CENTRAL INDEX KEY: 0001789317 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37449 FILM NUMBER: 24513927 MAIL ADDRESS: STREET 1: C/O VIELA BIO, INC., ONE MEDIMMUNE WAY STREET 2: FIRST FLOOR, AREA TWO CITY: GAITHERSBURG STATE: MD ZIP: 20878 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 wk-form4_1704413131.xml FORM 4 X0508 4 2024-01-02 0 0001626199 ALPINE IMMUNE SCIENCES, INC. ALPN 0001789317 Drappa Jorn C/O ALPINE IMMUNE SCIENCES, INC. 188 EAST BLAINE STREET, SUITE 200 SEATTLE WA 98102 1 0 0 0 0 Stock Option (Right to buy) 19 2024-01-02 4 A 0 17500 0 A 2034-01-01 Common Stock 17500 17500 D The exercise price is equal to the closing price per share of Common Stock as reported on the Nasdaq Global Market on the date of grant. 1/12th of the shares subject to the option become vested and exercisable on February 2, 2024 and 1/12 of the shares subject to the option shall vest monthly thereafter. /s/ James Paul Rickey, attorney-in-fact 2024-01-04