0001626199-24-000072.txt : 20240510 0001626199-24-000072.hdr.sgml : 20240510 20240510192243 ACCESSION NUMBER: 0001626199-24-000072 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240508 FILED AS OF DATE: 20240510 DATE AS OF CHANGE: 20240510 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FUHS ULRICH MARTIN CENTRAL INDEX KEY: 0002018119 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37449 FILM NUMBER: 24936545 MAIL ADDRESS: STREET 1: C/O ALPINE IMMUNE SCIENCES, INC. STREET 2: 185 EAST BLAINE STREET, SUITE 200 CITY: SEATTLE STATE: WA ZIP: 98102 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_1715383352.xml FORM 4 X0508 4 2024-05-08 0 0001626199 ALPINE IMMUNE SCIENCES, INC. ALPN 0002018119 FUHS ULRICH MARTIN C/O ALPINE IMMUNE SCIENCES, INC. 188 EAST BLAINE STREET, SUITE 200 SEATTLE WA 98102 0 1 0 0 Chief Accounting Officer 0 Common Stock 2024-05-08 4 M 0 22820 12.07 A 30120 D Stock Option (Right to buy) 12.07 2024-05-08 4 M 0 22820 0 D 2031-12-05 Common Stock 22820 52180 D Includes 7,300 shares of common stock underlying a restricted stock unit grant made on March 14, 2024. 1/4th of the shares subject to the option vested on November 30, 2022, and one thirty-sixth (1/36th) of the remaining shares subject to the option shall vest each month thereafter, subject to the reporting person continuing to be a service provider through each date. /s/ James Paul Rickey, attorney-in-fact 2024-05-10