0001567619-19-019762.txt : 20191018 0001567619-19-019762.hdr.sgml : 20191018 20191018170922 ACCESSION NUMBER: 0001567619-19-019762 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20191018 DATE AS OF CHANGE: 20191018 EFFECTIVENESS DATE: 20191018 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Icosavax, Inc. CENTRAL INDEX KEY: 0001786255 IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-351428 FILM NUMBER: 191158375 BUSINESS ADDRESS: STREET 1: 2815 EASTLAKE AVE E, SUITE 300 CITY: SEATTLE STATE: WA ZIP: 98102 BUSINESS PHONE: (206) 336-5600 MAIL ADDRESS: STREET 1: 2815 EASTLAKE AVE E, SUITE 300 CITY: SEATTLE STATE: WA ZIP: 98102 D 1 primary_doc.xml X0708 D LIVE 0001786255 Icosavax, Inc. 2815 Eastlake Ave E, Suite 300 Seattle WA WASHINGTON 98102 (206) 336-5600 DELAWARE None None Corporation true 2017 Tadataka Yamada, M.D. 2815 Eastlake Ave E, Suite 300 Seattle WA WASHINGTON 98102 Director Chairman of the Board Adam K. Simpson 2815 Eastlake Ave E, Suite 300 Seattle WA WASHINGTON 98102 Executive Officer Director President and Chief Executive Officer Douglas A. Holtzman 2815 Eastlake Ave E, Suite 300 Seattle WA WASHINGTON 98102 Executive Officer Chief Scientific Officer, Treasurer and Secretary Charles Richardson 2815 Eastlake Ave E, Suite 300 Seattle WA WASHINGTON 98102 Executive Officer Senior Vice President, Technical Operations Mark McDade 2815 Eastlake Ave E, Suite 300 Seattle WA WASHINGTON 98102 Director Terry Gould 2815 Eastlake Ave E, Suite 300 Seattle WA WASHINGTON 98102 Director Jason Hafler 2815 Eastlake Ave E, Suite 300 Seattle WA WASHINGTON 98102 Director Eric Moessinger 2815 Eastlake Ave E, Suite 300 Seattle WA WASHINGTON 98102 Director Niranjan Kanesa-thasan 2815 Eastlake Ave E, Suite 300 Seattle WA WASHINGTON 98102 Executive Officer Chief Medical Officer Biotechnology Decline to Disclose 06b false 2019-08-15 true true false 0 51007373 30007376 20999997 false 22 0 0 0 false Icosavax, Inc. /s/ Adam K. Simpson Adam K.Simpson President and Chief Executive Officer 2019-10-08