Filing Details

Accession Number:
0000899243-19-001661
Form Type:
4
Zero Holdings:
No
Publication Time:
2019-01-22 20:44:37
Reporting Period:
2019-01-18
Accepted Time:
2019-01-22 20:44:37
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1626199 Alpine Immune Sciences Inc. ALPN () 4
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1413350 Jay Venkatesan C/O Alpine Immune Sciences, Inc.
201 Elliott Avenue West, Suite 230
Seattle WA 98119
Yes No Yes No
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings Equity Swap Involved Form Type Code Nature of Ownership Explanation
Common Stock Acquisiton 2019-01-18 190,875 $5.37 3,994,781 No 4 P Indirect Alpine ImmunoSciences, L.P.
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 P Indirect Alpine ImmunoSciences, L.P.
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock Warrant (right to buy) Acquisiton 2019-01-18 74,441 $0.00 74,441 $12.74
Remaning Holdings Exercise Date Expiration Date Equity Swap Involved Transaction Form Type Transaction Code Nature of Ownership
74,441 2019-01-18 2024-01-18 No 4 P Indirect
Reported Non-Derivative Holdings
Sec. Name Remaning Holdings Nature of Ownership Explanation
Common Stock 18,633 Indirect By Raj Venkatesan as UTMA custodian for Reid Coleman Venkatesan
Common Stock 18,633 Indirect By Raj Venkatesan as UTMA custodian for Nathaniel Graham Venkatesan
Common Stock 21,739 Direct
Footnotes
  1. Represents 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.
  2. Alpine BioVentures GP, LLC is the general partner of Alpine ImmunoSciences, L.P. Dr. Venkatesan is a Managing Partner of Alpine BioVentures GP, LLC. Dr. Venkatesan is also a limited partner of Alpine ImmunoSciences, L.P. By virtue of such relationships, Dr. Venkatesan 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.
  3. The 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.
  4. These shares are held by Raj Venkatesan as custodian for Reporting Person's sons under the California Uniform Transfers to Minors Act.