0001626199-21-000132.txt : 20210929 0001626199-21-000132.hdr.sgml : 20210929 20210929162350 ACCESSION NUMBER: 0001626199-21-000132 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20210929 DATE AS OF CHANGE: 20210929 EFFECTIVENESS DATE: 20210929 FILER: COMPANY DATA: COMPANY CONFORMED NAME: ALPINE IMMUNE SCIENCES, INC. CENTRAL INDEX KEY: 0001626199 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 208969493 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-415077 FILM NUMBER: 211291965 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 D 1 primary_doc.xml X0708 D LIVE 0001626199 ALPINE IMMUNE SCIENCES, INC. 188 EAST BLAINE ST., SUITE 200 SEATTLE WA WASHINGTON 98102 206-788-4545 DELAWARE Nivalis Therapeutics, Inc. N30 Pharmaceuticals, Inc. Corporation true James Paul Rickey 188 East Blaine St., Suite 200 Seattle WA WASHINGTON 98102 Executive Officer Senior Vice President and Chief Financial Officer Mitchell Gold 188 East Blaine St., Suite 200 Seattle WA WASHINGTON 98102 Executive Officer Director Executive Chairman and Chief Executive Officer Stanford Peng 188 East Blaine St., Suite 200 Seattle WA WASHINGTON 98102 Executive Officer President and Head of Research and Development Robert Conway 188 East Blaine St., Suite 200 Seattle WA WASHINGTON 98102 Director Christopher Peetz 188 East Blaine St., Suite 200 Seattle WA WASHINGTON 98102 Director Natasha Hernday 188 East Blaine St., Suite 200 Seattle WA WASHINGTON 98102 Director Peter Thompson 188 East Blaine St., Suite 200 Seattle WA WASHINGTON 98102 Director James Topper 188 East Blaine St., Suite 200 Seattle WA WASHINGTON 98102 Director Jay Venkatesan 188 East Blaine St., Suite 200 Seattle WA WASHINGTON 98102 Director Cui Xiangmin 188 East Blaine St., Suite 200 Seattle WA WASHINGTON 98102 Director Zelanna Goldberg 188 East Blaine St., Suite 200 Seattle WA WASHINGTON 98102 Executive Officer Biotechnology Decline to Disclose 06b false 2021-09-17 false true true true false 0 91003125 90999934 3191 The Issuer issued and sold 6,489,357 shares and 3,191,487 prefunded warrants to purchase shares at an exercise price of $0.001 per share. The purchase price of the shares and the prefunded warrants was $9.40 per security. false 16 0 0 0 false ALPINE IMMUNE SCIENCES, INC. /s/ James Paul Rickey James Paul Rickey Senior VP and CFO 2021-09-29