Sec Form 4 Filing - Qiming U.S. Healthcare Fund II, L.P. @ Icosavax, Inc. - 2021-08-02

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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
Qiming U.S. Healthcare Fund II, L.P.
2. Issuer Name and Ticker or Trading Symbol
Icosavax, Inc. [ ICVX]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
_____ Officer (give title below) X __ Other (specify below)
Former 10% Owner
(Last) (First) (Middle)
11100 NE 8TH ST. SUITE 200,
3. Date of Earliest Transaction (MM/DD/YY)
08/02/2021
(Street)
BELLEVUE, WA98004
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 08/02/2021 C 3,310,228 A $ 0 ( 1 ) 3,310,228 D ( 2 )
Common Stock 08/02/2021 P( 5 ) 200,000 A $ 15 3,510,228 D ( 2 )
Common Stock 08/02/2021 P 8,018 A $ 15 3,518,246 D ( 3 )
Common Stock 08/02/2021 P 13,333 A $ 15 3,523,561 D ( 4 )
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
Series A-1 Preferred Stock $ 0 08/02/2021 C 12,480,498 ( 1 ) ( 1 ) Common Stock 3,003,224 ( 1 ) 0 D ( 2 )
Series B-1 Preferred Stock $ 0 08/02/2021 C 1,275,817 ( 1 ) ( 1 ) Common Stock 307,004 ( 1 ) 0 D ( 2 )
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Qiming U.S. Healthcare Fund II, L.P.
11100 NE 8TH ST. SUITE 200
BELLEVUE, WA98004
Former 10% Owner
Qiming U.S. Healthcare GP II, LLC
11100 NE 8TH ST
SUITE 200
BELLEVUE, WA98004
Former 10% Owner
MCDADE MARK
11100 NE 8TH ST
SUITE 200
BELLEVUE, WA98004
Former 10% Owner
Signatures
/s/ Qiming U.S. Healthcare Fund II, L.P., by Qiming U.S. Healthcare GP II, LLC, its General Partner 08/02/2021
Signature of Reporting Person Date
/s/ Mark McDade 08/02/2021
Signature of Reporting Person Date
Explanation of Responses:
( 1 )On August 2, 2021, the shares of Series A-1 Preferred Stock and Series B-1 Preferred Stock converted into shares of the Issuer's common stock at a ratio of 4.1557-for-1 automatically upon the closing of the Issuer's initial public offering without payment or further consideration. The shares have no expiration date. As a result of the Issuer's initial public offering, Qiming U.S. Healthcare Fund II, L.P. ("Qiming") is no longer a 10% owner of the Issuer and is therefore no longer subject to Section 16 in connection with its transactions in the equity securities of the Issuer.
( 2 )The securities are directly held by Qiming. Qiming U.S. Healthcare GP II, LLC ("Qiming GP") is the General Partner of Qiming. Gary Rieschel and Mark McDade are the managing members of Qiming GP. As a result, each of Qiming GP and Messrs. Rieschel and McDade may be deemed to beneficially own the shares held by Qiming.
( 3 )Shares reported herein as purchased on August 2, 2021 represent 8,018 shares of Common Stock purchased by Mark McDade.
( 4 )Shares reported herein as purchased on August 2, 2021 represent 13,333 shares of Common Stock purchased by Gary Rieschel.
( 5 )Shares reported herein as purchased on August 2, 2021 represent 200,000 shares of Common Stock purchased by Qiming.

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