SEC Form 4 · accession 0000899243-19-001662
ALPINE IMMUNE SCIENCES, INC. · ALPN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Mitchell Gold
Officer — Executive Chairman and CEO · Director · 10% Owner
Period of report
Jan 18, 2019
Accepted (ET)
Jan 22, 2019 · 8:44 pm EST
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,F3 | Jan 18, 2019 | P | 190,875 | $5.37 | A | 3,994,781 | I | Alpine ImmunoSciences, L.P. |
| Common Stock | May 14, 2018 | G | 3,000 | $0.00 | D | 20,292 | D | |
| Common Stock | May 15, 2018 | G | 3,000 | $0.00 | D | 17,292 | D | |
| Common Stock | May 21, 2018 | G | 6,000 | $0.00 | D | 11,292 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Warrant (right to buy)F1,F2,F3 | $12.74 | Jan 18, 2019 | P | 74,441 | A | Jan 18, 2019 | Jan 18, 2024 | Common Stock | 74,441 | 74,441 | I |
Explanation of responses
- F1Represents shares acquired in a private placement pursuant to that Securities Purchase Agreement, dated as of January 15, 2019, by and among the Issuer and the Purchasers set forth on the signature pages thereto (the "Securities Purchase Agreement"). Pursuant to the terms of the Securities Purchase Agreement, investors purchased common stock units for $5.37 per common stock unit. Each common stock unit consisted of one share of the Company's Common Stock and a warrant to purchase 0.39 shares of the Company's Common Stock.
- F2Alpine BioVentures GP, LLC is the general partner of Alpine ImmunoSciences, L.P. Dr. Gold is a Managing Partner of Alpine BioVentures GP, LLC. Dr. Gold is also a limited partner of Alpine ImmunoSciences, L.P. By virtue of such relationships, Dr. Gold may be deemed to have voting and investment power with respect to the shares held by Alpine ImmunoSciences, L.P. and as a result may be deemed to have beneficial ownership of such shares.
- F3The Reporting Person disclaims beneficial ownership of the shares of common stock reported herein except to the extent of his pecuniary interest therein, if any, and this report shall not be deemed an admission that the Reporting Person is the beneficial owner of the shares for purposes of Section 16 of the Securities Exchange Act of 1934, as amended, or for any other purpose.