0001626199-24-000076.txt : 20240510 0001626199-24-000076.hdr.sgml : 20240510 20240510192652 ACCESSION NUMBER: 0001626199-24-000076 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: PENG STANFORD L CENTRAL INDEX KEY: 0001711352 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37449 FILM NUMBER: 24936554 MAIL ADDRESS: STREET 1: ALPINE IMMUNE SCIENCES, INC. STREET 2: 188 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_1715383601.xml FORM 4 X0508 4 2024-05-08 0 0001626199 ALPINE IMMUNE SCIENCES, INC. ALPN 0001711352 PENG STANFORD L C/O ALPINE IMMUNE SCIENCES, INC. 188 EAST BLAINE STREET, SUITE 200 SEATTLE WA 98102 0 1 0 0 See Remarks 0 Common Stock 2024-05-08 4 M 0 7025 13.20 A 79396 D Common Stock 2024-05-08 4 M 0 3126 6.51 A 82522 D Common Stock 2024-05-08 4 M 0 37267 0.65 A 119789 D Common Stock 2024-05-08 4 M 0 161492 0.65 A 281281 D Common Stock 2024-05-08 4 M 0 22593 11.31 A 303874 D Common Stock 2024-05-08 4 M 0 26912 3.23 A 330786 D Common Stock 2024-05-08 4 M 0 13377 6.33 A 344163 D Stock Option (Right to buy) 13.20 2024-05-08 4 M 0 7025 0 D 2031-01-04 Common Stock 7025 142975 D Stock Option (Right to buy) 6.51 2024-05-08 4 M 0 3126 0 D 2029-02-05 Common Stock 3126 71874 D Stock Option (Right to buy) 0.65 2024-05-08 4 M 0 37267 0 D 2027-03-13 Common Stock 37267 0 D Stock Option (Right to buy) 0.65 2024-05-08 4 M 0 161492 0 D 2026-09-21 Common Stock 161492 0 D Stock Option (Right to buy) 11.31 2024-05-08 4 M 0 22593 0 D 2028-01-01 Common Stock 22593 42407 D Stock Option (Right to buy) 3.23 2024-05-08 4 M 0 26912 0 D 2030-01-22 Common Stock 26912 81088 D Stock Option (Right to buy) 6.33 2024-05-08 4 M 0 13377 0 D 2028-09-27 Common Stock 13377 236623 D Includes 48,000 shares of common stock underlying a restricted stock unit grant made on January 4, 2024. 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. One-fourth (1/4) of the shares subject to the option will vest on January 5, 2022, and one thirty-sixth (1/36th) of the remaining shares subject to the option shall vest each month thereafter, subject to Reporting Person continuing to be a service provider through each such date. One-fourth (1/4) of the shares subject to the option will vest on February 6, 2020, and one thirty-sixth (1/36th) of the remaining shares subject to the option shall vest each month thereafter, subject to Reporting Person continuing to be a service provider through each such date. One-fourth (1/4) of the shares subject to the option will vest on September 6, 2017, and one thirty-sixth (1/36th) of the remaining shares subject to the option shall vest each month thereafter, subject to Reporting Person continuing to be a service provider through each such date. One-fourth (1/4) of the shares subject to the option will vest on January 2, 2019, and one thirty-sixth (1/36th) of the remaining shares subject to the option shall vest each month thereafter, subject to Reporting Person continuing to be a service provider through each such date. One-fourth (1/4) of the shares subject to the option will vest on January 23, 2021, and one thirty-sixth (1/36th) of the remaining shares subject to the option shall vest each month thereafter, subject to Reporting Person continuing to be a service provider through each such date. 1/2 of the shares subject to the option become vested and exercisable on October 1, 2020 and the balance of the shares subject to the option become vested and exercisable on October 1, 2022, subject to continued service through each such date. /s/ James Paul Rickey, attorney-in-fact 2024-05-10