SEC Form 4 · accession 0001104659-17-003545
ALPINE IMMUNE SCIENCES, INC. · ALPN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
R Michael Carruthers
Officer — Interim President / CFO
Period of report
Jan 12, 2017
Accepted (ET)
Jan 23, 2017 · 4:23 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001626199
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (Right to Buy)F1,F2 | $2.21 | Jan 12, 2017 | A | 200,000 | A | — | Jan 12, 2020 | Common Stock | 200,000 | 200,000 | D |
Explanation of responses
- F1The 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.
- F2The options shall vest upon the closing of a change in control of the company or upon termination of Mr. Carruther's employment by Nivalis without cause or by Mr. Carruthers for good reason, and will have a term and be exercisable for a period of 36 months after the date of grant.