SEC Form 4 · accession 0000899243-17-019066
ALPINE IMMUNE SCIENCES, INC. · ALPN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
James N Topper
Director · 10% Owner
Period of report
Jul 24, 2017
Accepted (ET)
Jul 26, 2017 · 5:11 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001626199
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Jul 24, 2017 | A | 2,199,011 | — | A | 2,199,011 | I | See Footnotes |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Pursuant to that certain Agreement and Plan of Merger and Reorganization (the "Merger Agreement"), dated as of April 18, 2017, by and among the Issuer, Nautilus Merger Sub, Inc. and the corporation then known as Alpine Immune Sciences, Inc. ("Old Alpine"), each share of Old Alpine common stock was converted into 0.4969 shares of the Issuer's common stock (the "Exchange Ratio").
- F2The Reporting Person and Patrick Heron are the managing members of FHM Life Sciences VIII, L.L.C., which is the general partner of FHM Life Sciences VIII, L.P., which is the general partner of Frazier Life Sciences VIII, L.P. ("FLS VIII"), the record holder of the securities, and the Reporting Person may be deemed to share voting and dispositive power over the securities held by FLS VIII. The Reporting Person disclaims beneficial ownership over such securities except to the extent of his pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes.