Sec Form 3 Filing - Pepe Jeffrey C. @ Silverback Therapeutics, Inc. - 2022-09-02

Insider filing report for Changes in Beneficial Ownership
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FORM 3
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
Pepe Jeffrey C.
2. Issuer Name and Ticker or Trading Symbol
Silverback Therapeutics, Inc. [ SBTX]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
Interim CEO and GC
(Last) (First) (Middle)
C/O SILVERBACK THERAPEUTICS, INC., 500 FAIRVIEW AVENUE N, SUITE 600
3. Date of Earliest Transaction (MM/DD/YY)
09/02/2022
(Street)
SEATTLE, WA98109
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ 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 52,323 D
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
Stock option (right to buy) $ 1.68 ( 1 ) 09/10/2029 Common Stock 35,407 D
Stock option (right to buy) $ 1.27 ( 2 ) 04/28/2030 Common Stock 22,401 D
Stock option (right to buy) $ 1.27 ( 3 ) 04/28/2030 Common Stock 17,619 D
Stock option (right to buy) $ 1.27 ( 4 ) 04/28/2030 Common Stock 18,268 D
Stock option (right to buy) $ 6.65 ( 5 ) 09/30/2030 Common Stock 26,932 D
Stock option (right to buy) $ 21 ( 6 ) 12/02/2030 Common Stock 102,039 D
Stock option (right to buy) $ 4.85 ( 7 ) 01/31/2032 Common Stock 45,000 D
Stock option (right to buy) $ 4.85 ( 8 ) 01/31/2032 Common Stock 28,500 D
Stock option (right to buy) $ 3.15 ( 9 ) 05/01/2032 Common Stock 79,261 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Pepe Jeffrey C.
C/O SILVERBACK THERAPEUTICS, INC.
500 FAIRVIEW AVENUE N, SUITE 600
SEATTLE, WA98109
Interim CEO and GC
Signatures
/s/ Jeffrey C. Pepe 09/07/2022
Signature of Reporting Person Date
Explanation of Responses:
( 1 )25% of the shares subject to the option vested on August 19, 2020, and the remaining shares will vest monthly thereafter over three years.
( 2 )25% of the shares subject to the option vested on March 4, 2021, and the remaining shares will vest monthly thereafter over three years.
( 3 )25% of the shares subject to the option vested on July 1, 2021, and the remaining shares will vest monthly thereafter over three years.
( 4 )The shares subject to the option will vest in equal monthly installments over the 48 months beginning on October 18, 2020.
( 5 )The shares subject to the option will vest in equal monthly installments over the 48 months beginning on October 22, 2020.
( 6 )The shares subject to the option will vest in equal monthly installments over the 48 months beginning on January 3, 2021.
( 7 )The shares subject to the option will vest in equal monthly installments over the 48 months beginning on March 1, 2022.
( 8 )25% of the shares subject to the option will vest on February 1, 2023, and the remaining shares will vest monthly thereafter over three years.
( 9 )The shares subject to the option will vest on May 2, 2023.

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).

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