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