Sec Form 4 Filing - Alpine ImmunoSciences, L.P. @ ALPINE IMMUNE SCIENCES, INC. - 2020-12-22

Insider filing report for Changes in Beneficial Ownership
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FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
Alpine ImmunoSciences, L.P.
2. Issuer Name and Ticker or Trading Symbol
ALPINE IMMUNE SCIENCES, INC. [ ALPN]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director X __ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
600 STEWART STREET, SUITE 1503
3. Date of Earliest Transaction (MM/DD/YY)
12/22/2020
(Street)
SEATTLE, WA98101
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
_____ Form filed by One Reporting Person
__ X __ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 12/22/2020 J( 1 ) 993,801 D $ 0 ( 1 ) 3,000,980 D ( 2 )
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4, and 5)
6. Date Exercisable and Expiration Date
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Alpine ImmunoSciences, L.P.
600 STEWART STREET, SUITE 1503
SEATTLE, WA98101
X
Alpine Bioventures, GP, LLC
600 STEWART STREET, SUITE 1503
SEATTLE, WA98101
X
Signatures
/s/ Mitchell Gold, attorney-in-fact 12/22/2020
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Alpine ImmunoSciences, L.P. distributed these shares to its limited partners on a pro rata basis for no consideration.
( 2 )Alpine BioVentures GP, LLC ("ABV LLC") is the general partner of the Reporting Person. Dr. Mitchell Gold and Dr. Jay Venkatesan are the Managing Partners of ABV LLC. Dr. Gold and Dr. Venkatesan are also limited partners of the Reporting Person. By virtue of their positions as Managing Partners of ABV LLC, Dr. Gold and Dr. Venkatesan may be deemed to have voting and investment power with respect to the shares held by the Reporting Person and as a result may be deemed to have beneficial ownership of such shares. Each of Dr. Gold and Dr. Venkatesan disclaims beneficial ownership of the shares held by the Reporting Person, except to the extent of his pecuniary interest therein, if any, and this report shall not be deemed an admission that the Reporting Person, Dr. Gold or Dr. Venkatesan 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.

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* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
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