0001567619-21-007745.txt : 20210407 0001567619-21-007745.hdr.sgml : 20210407 20210407152940 ACCESSION NUMBER: 0001567619-21-007745 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20210407 DATE AS OF CHANGE: 20210407 EFFECTIVENESS DATE: 20210407 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: 021-394949 FILM NUMBER: 21811946 BUSINESS ADDRESS: STREET 1: 1616 EASTLAKE AVE E, SUITE 208 CITY: SEATTLE STATE: WA ZIP: 98102 BUSINESS PHONE: (858) 775-4523 MAIL ADDRESS: STREET 1: 1616 EASTLAKE AVE E, SUITE 208 CITY: SEATTLE STATE: WA ZIP: 98102 D 1 primary_doc.xml X0708 D LIVE 0001786255 Icosavax, Inc. 1616 Eastlake Ave. E, Ste. 208 Seattle WA WASHINGTON 98102 (858) 775-4523 DELAWARE None None Corporation true 2017 Tadataka Yamada, M.D. 1616 Eastlake Ave. E, Ste. 208 Seattle WA WASHINGTON 98102 Director Chairman of the Board Adam K. Simpson 1616 Eastlake Ave. E, Ste. 208 Seattle WA WASHINGTON 98102 Director Executive Officer President and Chief Executive Officer Douglas A. Holtzman 1616 Eastlake Ave. E, Ste. 208 Seattle WA WASHINGTON 98102 Executive Officer Chief Scientific Officer and Secretary Charles Richardson 1616 Eastlake Ave. E, Ste. 208 Seattle WA WASHINGTON 98102 Executive Officer Senior Vice President, Technical Operations Mark McDade 1616 Eastlake Ave. E, Ste. 208 Seattle WA WASHINGTON 98102 Director Terry Gould 1616 Eastlake Ave. E, Ste. 208 Seattle WA WASHINGTON 98102 Director Jason Hafler 1616 Eastlake Ave. E, Ste. 208 Seattle WA WASHINGTON 98102 Director Eric Moessinger 1616 Eastlake Ave. E, Ste. 208 Seattle WA WASHINGTON 98102 Director Niranjan Kanesa-thasan 1616 Eastlake Ave. E, Ste. 208 Seattle WA WASHINGTON 98102 Executive Officer Chief Medical Officer Peter Kolchinsky 1616 Eastlake Ave. E, Ste. 208 Seattle WA WASHINGTON 98102 Director Cassia Cearley 1616 Eastlake Ave. E, Ste. 208 Seattle WA WASHINGTON 98102 Executive Officer Treasurer, Chief Business Officer Biotechnology Decline to Disclose 06b false 2021-03-19 false true false 0 99729701 99729701 0 false 36 0 0 0 false Icosavax, Inc. /s/ Adam K. Simpson Adam K. Simpson President and Chief Executive Officer 2021-04-07