Insider filing report for Changes in Beneficial Ownership
- Schedule 13G & 13D forms are used to report a party's ownership of stock which exceeds 5% of a company's total stock issue.
- Schedule 13G is a shorter version of Schedule 13D with fewer reporting requirements.
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SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
SCHEDULE 13G
(Rule 13d-102)
INFORMATION TO BE INCLUDED IN STATEMENTS FILED PURSUANT TO § 240.13d-1
(b), (c) AND (d) AND AMENDMENTS THERETO FILED PURSUANT TO § 240.13d-2
Alpine Immune Sciences, Inc.
(Name of Issuer)
Common Stock
(Title of Class of Securities)
02083G100
(CUSIP Number)
July 28, 2020
(Date of Event Which Requires Filing of this Statement)
Check the appropriate box to designate the rule pursuant to which this Schedule is filed:
☐ Rule 13d-1(b)
☒ Rule 13d-1(c)
☐ Rule 13d-1(d)
* | The remainder of this cover page shall be filled out for a reporting persons initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures provided in a prior cover page. |
The information required on the remainder of this cover page shall not be deemed to be filed for the purpose of Section 18 of the Securities Exchange Act of 1934 (Act) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).
CUSIP NO. 02083G100 | 13G | Page 2 of 11 Pages |
1 | NAMES OF REPORTING PERSONS
Omega Fund VI, L.P. | |||||
2 | CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS) (a) ☐ (b) ☒ (1)
| |||||
3 | SEC USE ONLY
| |||||
4 | CITIZENSHIP OR PLACE OF ORGANIZATION
Cayman Islands |
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH |
5 | SOLE VOTING POWER
0 | ||||
6 | SHARED VOTING POWER
1,670,370 | |||||
7 | SOLE DISPOSITIVE POWER
0 | |||||
8 | SHARED DISPOSITIVE POWER
1,670,370 |
9 |
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
1,670,370 | |||||
10 | CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
☐ | |||||
11 | PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
6.9% (2) | |||||
12 | TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
PN |
(1) | This Schedule 13G is filed by Omega Fund VI, L.P. (Omega Fund), Omega Fund VI GP, L.P. (Omega GP), Omega Fund VI GP Manager, Ltd. (Omega Ltd), Claudio Nessi (Nessi), Otello Stampacchia (Stampacchia), and Anne-Mari Paster (Paster) (together, the Reporting Persons). Omega Ltd serves as the general partner of Omega GP, which serves as the general partner of Omega Fund; and each of Omega Ltd and Omega GP may be deemed to own beneficially the shares held by Omega Fund. Nessi, Stampacchia, and Paster are the directors of Omega Ltd and may be deemed to beneficially own the shares held by Omega Fund. The Reporting Persons may be deemed a group for purposes of Section 13 of the Exchange Act and expressly disclaim status as a group for purposes of this Schedule 13G. |
(2) | The following percentages are based on (i) 18,587,892 shares of Common Stock outstanding as of May 7, 2020, as set forth in the Issuers quarterly report filed on Form 10-Q with the Securities and Exchange Commission on May 14, 2020, (ii) 5,139,610 shares of Common Stock issued in a private placement transaction pursuant to a Securities Purchase Agreement dated July 24, 2020, filed with the issuers most recent Form 8-K with the Securities and Exchange Commission on July 24, 2020 and (iii) 385,470 shares of Common Stock that are subject to immediately exercisable Warrants held by Omega Fund. |
CUSIP NO. 02083G100 | 13G | Page 3 of 11 Pages |
1 | NAMES OF REPORTING PERSONS
Omega Fund VI GP, L.P. | |||||
2 | CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS) (a) ☐ (b) ☒ (1)
| |||||
3 | SEC USE ONLY
| |||||
4 | CITIZENSHIP OR PLACE OF ORGANIZATION
Cayman Islands |
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH |
5 | SOLE VOTING POWER
0 | ||||
6 | SHARED VOTING POWER
1,670,370 | |||||
7 | SOLE DISPOSITIVE POWER
0 | |||||
8 | SHARED DISPOSITIVE POWER
1,670,370 |
9 |
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
1,670,370 | |||||
10 | CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
☐ | |||||
11 | PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
6.9% (2) | |||||
12 | TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
PN |
(1) | This Schedule 13G is filed by Omega Fund VI, L.P. (Omega Fund), Omega Fund VI GP, L.P. (Omega GP), Omega Fund VI GP Manager, Ltd. (Omega Ltd), Claudio Nessi (Nessi), Otello St ampacchia (Stampacchia), and Anne-Mari Paster (Paster) (together, the Reporting Persons). Omega Ltd serves as the general partner of Omega GP, which serves as the general partner of Omega Fund; and each of Omega Ltd and Omega GP may be deemed to own beneficially the shares held by Omega Fund. Nessi, Stampacchia, and Paster are the directors of Omega Ltd and may be deemed to beneficially own the shares held by Omega Fund. The Reporting Persons may be deemed a group for purposes of Section 13 of the Exchange Act and expressly disclaim status as a group for purposes of this Schedule 13G. |
(2) | The following percentages are based on (i) 18,587,892 shares of Common Stock outstanding as of May 7, 2020, as set forth in the Issuers quarterly report filed on Form 10-Q with the Securities and Exchange Commission on May 14, 2020, (ii) 5,139,610 shares of Common Stock issued in a private placement transaction pursuant to a Securities Purchase Agreement dated July 24, 2020, filed with the issuers most recent Form 8-K with the Securities and Exchange Commission on July 24, 2020 and (iii) 385,470 shares of Common Stock that are subject to immediately exercisable Warrants held by Omega Fund. |
CUSIP NO. 02083G100 | 13G | Page 4 of 11 Pages |
1 | NAMES OF REPORTING PERSONS
Omega Fund VI GP Manager, Ltd. | |||||
2 | CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS) (a) ☐ (b) ☒ (1)
| |||||
3 | SEC USE ONLY
| |||||
4 | CITIZENSHIP OR PLACE OF ORGANIZATION
Cayman Islands |
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH |
5 | SOLE VOTING POWER
0 | ||||
6 | SHARED VOTING POWER
1,670,370 | |||||
7 | SOLE DISPOSITIVE POWER
0 | |||||
8 | SHARED DISPOSITIVE POWER
1,670,370 |
9 |
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
1,670,370 | |||||
10 | CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
☐ | |||||
11 | PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
6.9% (2) | |||||
12 | TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
OO |
(1) | This Schedule 13G is filed by Omega Fund VI, L.P. (Omega Fund), Omega Fund VI GP, L.P. (Omega GP), Omega Fund VI GP Manager, Ltd. (Omega Ltd), Claudio Nessi (Nessi), Otello Stampacchia (Stampacchia), and Anne-Mari Paster (Paster) (together, the Reporting Persons). Omega Ltd serves as the general partner of Omega GP, which serves as the general partner of Omega Fund; and each of Omega Ltd and Omega GP may be deemed to own beneficially the shares held by Omega Fund. Nessi, Stampacchia, and Paster are the directors of Omega Ltd and may be deemed to beneficially own the shares held by Omega Fund. The Reporting Persons may be deemed a group for purposes of Section 13 of the Exchange Act and expressly disclaim status as a group for purposes of this Schedule 13G. |
(2) | The following percentages are based on (i) 18,587,892 shares of Common Stock outstanding as of May 7, 2020, as set forth in the Issuers quarterly report filed on Form 10-Q with the Securities and Exchange Commission on May 14, 2020, (ii) 5,139,610 shares of Common Stock issued in a private placement transaction pursuant to a Securities Purchase Agreement dated July 24, 2020, filed with the issuers most recent Form 8-K wi th the Securities and Exchange Commission on July 24, 2020 and (iii) 385,470 shares of Common Stock that are subject to immediately exercisable Warrants held by Omega Fund. |
CUSIP NO. 02083G100 | 13G | Page 5 of 11 Pages |
1 | NAMES OF REPORTING PERSONS
Claudio Nessi | |||||
2 | CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS) (a) ☐ (b) ☒ (1)
| |||||
3 | SEC USE ONLY
| |||||
4 | CITIZENSHIP OR PLACE OF ORGANIZATION
Switzerland |
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH |
5 | SOLE VOTING POWER
0 | ||||
6 | SHARED VOTING POWER
1,670,370 | |||||
7 | SOLE DISPOSITIVE POWER
0 | |||||
8 | SHARED DISPOSITIVE POWER
1,670,370 |
9 |
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
1,670,370 | |||||
10 | CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
☐ | |||||
11 | PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
6.9% (2) | |||||
12 | TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
IN |
(1) | This Schedule 13G is filed by Omega Fund VI, L.P. (Omega Fund), Omega Fund VI GP, L.P. (Omega GP), Omega Fund VI GP Manager, Ltd. (Omega Ltd), Claudio Nessi (Nessi), Otello Stampacchia (Stampacchia), and Anne-Mari Paster (Paster) (together, the Reporting Persons). Omega Ltd serves as the general partner of Omega GP, which serves as the general partner of Omega Fund; and each of Omega Ltd and Omega GP may be deemed to own beneficially the shares held by Omega Fund. Nessi, Stampacchia, and Paster are the directors of Omega Ltd and may be deemed to beneficially own the shares held by Omega Fund. The Reporting Persons may be deemed a group for purposes of Section 13 of the Exchange Act and expressly disclaim status as a group for purposes of this Schedule 13G. |
(2) | The following percentages are based on (i) 18,587,892 shares of Common Stock outstanding as of May 7, 2020, as set forth in the Issuers quarterly report filed on Form 10-Q with the Securities and Exchange Commission on May 14, 2020, (ii) 5,139,610 shares of Common Stock issued in a private placement transaction pursuant to a Securities Purchase Agreement dated July 24, 2020, filed with the issuers most recent Form 8-K with the Securities and Exchange Commission on July 24, 2020 and (iii) 385,470 shares of Common Stock that are subject to immediately exercisable Warrants held by Omega Fund. |
CUSIP NO. 02083G100 | 13G | Page 6 of 11 Pages |
1 | NAMES OF REPORTING PERSONS
Otello Stampacchia | |||||
2 | CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS) (a) ☐ (b) ☒ (1)
| |||||
3 | SEC USE ONLY
| |||||
4 | CITIZENSHIP OR PLACE OF ORGANIZATION
Italy |
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH |
5 | SOLE VOTING POWER
0 | ||||
6 | SHARED VOTING POWER
1,670,370 | |||||
7 | SOLE DISPOSITIVE POWER
0 | |||||
8 | SHARED DISPOSITIVE POWER
1,670,370 |
9 |
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
1,670,370 | |||||
10 | CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
☐ | |||||
11 | PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
6.9% (2) | |||||
12 | TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
IN |
(1) | This Schedule 13G is filed by Omega Fund VI, L.P. (Omega Fund), Omega Fund VI GP, L.P. (Omega GP), Omega Fund VI GP Manager, Ltd. (Omega Ltd), Claudio Nessi (Nessi), Otello Stampacchia (Stampacchia), and Anne-Mari Paster (Paster) (together, the Reporting Persons). Omega Ltd serves as the general partner of Omega GP, which serves as the general partner of Omega Fund; and each of Omega Ltd and Omega GP may be deemed to own beneficially the shares held by Omega Fund. Nessi, Stampacchia, and Paster are the directors of Omega Ltd and may be deemed to beneficially own the shares held by Omega Fund. The Reporting Persons may be deemed a group for purposes of Section 13 of the Exchange Act and expressly disclaim status as a group for purposes of this Schedule 13G. |
(2) | The following percentages are based on (i) 18,587,892 shares of Common Stock outstanding as of May 7, 2020, as set forth in the Issuers quarterly report filed on Form 10-Q with the Securities and Exchange Commission on May 14, 2020, (ii) 5,139,610 shares of Common Stock issued in a private placement transaction pursuant to a Securities Purchase Agreement dated July 24, 2020, filed with the issuers most recent Form 8-K with the Securities and Exchange Commission on July 24, 2020 and (iii) 385,470 shares of Common Stock that are subject to immediately exercisable Warrants held by Omega Fund. |
CUSIP NO. 02083G100 | 13G | Page 7 of 11 Pages |
1 | NAMES OF REPORTING PERSONS
Anne-Mari Paster | |||||
2 | CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS) (a) ☐ (b) ☒ (1)
| |||||
3 | SEC USE ONLY
| |||||
4 | CITIZENSHIP OR PLACE OF ORGANIZATION
United States of America |
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH |
5 | SOLE VOTING POWER
0 | ||||
6 | SHARED VOTING POWER
1,670,370 | |||||
7 | SOLE DISPOSITIVE POWER
0 | |||||
8 | SHARED DISPOSITIVE POWER
1,670,370 |
9 |
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
1,670,370 | |||||
10 | CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
☐ | |||||
11 | PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
6.9% (2) | |||||
12 | TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
IN |
(1) | This Schedule 13G is filed by Omega Fund VI, L.P. (Omega Fund), Omega Fund VI GP, L.P. (Omega GP), Omega Fund VI GP Manager, Ltd. (Omega Ltd), Claudio Nessi (Nessi), Otello Stampacchia (Stampacchia), and Anne-Mari Paster (Paster) (together, the Reporting Persons). Omega Ltd serves as the general partner of Omega GP, which serves as the general partner of Omega Fund; and each of Omega Ltd and Omega GP may be deemed to own beneficially the shares held by Omega Fund. Nessi, Stampacchia, and Paster are the directors of Omega Ltd and may be deemed to beneficially own the shares held by Omega Fund. The Reporting Persons may be deemed a group for purposes of Section 13 of the Exchange Act and expressly disclaim status as a group for purposes of this Schedule 13G. |
(2) | The following percentages are based on (i) 18,587,892 shares of Common Stock outstanding as of May 7, 2020, as set forth in the Issuers quarterly report filed on Form 10-Q with the Securities and Exchange Commission on May 14, 2020, (ii) 5,139,610 shares of Common Stock issued in a private placement transaction pursuant to a Securities Purchase Agreement dated July 24, 2020, filed with the issuers most recent Form 8-K with the Securities and Exchange Commission on July 24, 2020 and (iii) 385,470 shares of Common Stock that are subject to immediately exercisable Warrants held by Omega Fund. |
CUSIP NO. 02083G100 | 13G | Page 8 of 11 Pages |
Introductory Note: This statement on Schedule 13G is filed on behalf of the Reporting Persons, in respect of shares of Common Stock (Common Stock), of Alpine Immune Science, Inc. (the Issuer).
Item 1(a) | Name of Issuer: |
Alpine Immune Science, Inc. (the Issuer)
Item 1(b) | Address of Issuers principal executive offices: |
Alpine Immune Science, Inc.
201 Elliott Avenue West, Suite 230
Seattle, WA 98119
Items 2(a) | Name of Reporting Persons filing: |
Omega Fund VI, L.P. (Omega Fund)
Omega Fund VI GP, L.P. (Omega GP)
Omega Fund VI GP Manager, Ltd. (Omega Ltd.)
Claudio Nessi (Nessi)
Otello Stampacchia (Stampacchia)
Anne-Mari Paster (Paster)
Ite m 2(b) | Address or principal business office or, if none, residence: |
The address of the principal business office of Omega Fund, Omega GP, Omega Ltd, Nessi, Stampacchia, and Paster, is c/o Omega Fund Management, LLC, 888 Boylston Street, Suite 1111, Boston, MA 02199.
Item 2(c) | Citizenship: |
Name | Citizenship or Place of Organization | |
Omega Fund |
Cayman Islands | |
Omega GP |
Cayman Islands | |
Omega Ltd. |
Cayman Islands | |
Nessi |
Switzerland | |
Stampacchia |
Italy | |
Paster |
United States of America |
Item 2(d) | Title of class of securities: |
Common Stock
Item 2(e) | CUSIP No.: |
02083G100
Item 3 | If this statement is filed pursuant to §§ 240.13d-1(b), or 240.13d-2(b) or (c), check whether the person filings is a: |
Not applicable.
Item 4 | Ownership |
The following information with respect to the ownership of Common Stock of the Issuer by the Reporting Persons filing this statement on Schedule 13G is provided as of July 28, 2020.
CUSIP NO. 02083G100 | 13G | Page 9 of 11 Pages |
Reporting Persons |
Shares of Common Stock Held Directly |
Sole Voting Power |
Shared Voting Power |
Sole Dispositive Power |
Shared Dispositive Power |
Beneficial Ownership |
Percentage of Class (1) |
|||||||||||||||||||||
Omega Fund(2)(3) |
1,670,370 | 0 | 1,670,370 | 0 | 1,670,370 | 1,670,370 | 6.9 | % | ||||||||||||||||||||
Omega GP(2)(3) |
0 | 0 | 1,670,370 | 0 | 1,670,370 | 1,670,370 | 6.9 | % | ||||||||||||||||||||
Omega Ltd(2)(3) |
0 | 0 | 1,670,370 | 0 | 1,670,370 | 1,670,370 | 6.9 | % | ||||||||||||||||||||
Nessi(2)(3) |
0 | 0 | 1,670,370 | 0 | 1,670,370 | 1,670,370 | 6.9 | % | ||||||||||||||||||||
Stampacchia(2)(3) |
0 | 0 | 1,670,370 | 0 | 1,670,370 | 1,670,370 | 6.9 | % | ||||||||||||||||||||
Paster(2)(3) |
0 | 0 | 1,670,370 | 0 | 1,670,370 | 1,670,370 | 6.9 | % |
(1) | The following percentages are based on (i) 18,587,892 shares of Common Stock outstanding as of May 7, 2020, as set forth in the Issuers quarterly report filed on Form 10-Q with the Securities and Exchange Commission on May 14, 2020, (ii) 5,139,610 shares of Common Stock issued in a private placement transaction pursuant to a Securities Purchase Agreement dated July 24, 2020, filed with the issuers most recent Form 8-K with the Securities and Exchange Commission on July 24, 2020 and (iii) 385,470 shares of Common Stock that are subject to immediately exercisable Warrants held by Omega Fund. |
(2) | Omega Fund owns 1,284,900 shares of the Common Stock and 385,470 immediately exercisable Warrants. Omega Ltd serves as the general partner of Omega GP, which serves as the general partner of Omega Fund, and each of Omega GP and Omega Ltd may be deemed to own beneficially the shares and Warrants held by Omega Fund. Nessi, Stampacchia, and Paster are the directors of Omega Ltd and may be deemed to beneficially own the shares and Warrants held by Omega Fund. |
(3) | The Reporting Persons may be deemed a group for purposes of Section 13 of the Exchange Act and expressly disclaim status as a group for purposes of this Schedule 13G. |
Item 5 | Ownership of Five Percent or Less of a Class |
If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following: ☐
Item 6 | Ownership of More than Five Percent on Behalf of Another Person |
If this statement is being filed to report the fact that as of the date hereof, the Reporting Persons have ceased to be the beneficial owner of more than five percent of the class of securities, check the following: ☐
Item 7 | Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company or Control Person |
Not applicable.
Item 8 | Identification and Classification of Members of the Group |
Not applicable.
Item 9 | Notice of Dissolution of Group |
Not applicable.
Item 10 | Certifications |
By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were not acquired and are not held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as a participant in any transaction having that purpose or effect, other than activities solely in connection with a nomination under Rule 14a-11.
CUSIP NO. 02083G100 | 13G | Page 10 of 11 Pages |
SIGNATURES
After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.
Dated: August 6, 2020 | ||
OMEGA FUND VI, L.P. | ||
BY: | Omega Fund VI GP, L.P. | |
ITS: | GENERAL PARTNER | |
BY: | Omega Fund VI GP Manager, Ltd. | |
ITS: | GENERAL PARTNER | |
By: | /s/ Anne-Mari Paster | |
Director | ||
OMEGA FUND VI GP, L.P. | ||
BY: | Omega Fund VI GP Manager, Ltd. | |
ITS: | GENERAL PARTNER | |
By: | /s/ Anne-Mari Paster | |
Director | ||
OMEGA FUND VI GP MANAGER, LTD. | ||
By: | /s/ Anne-Mari Paster | |
Director | ||
/s/ * Anne-Mari Paster, as Attorney-in-Fact | ||
Claudio Nessi | ||
/s/ * Anne-Mari Paster, as Attorney-in-Fact | ||
Otello Stampacchia | ||
/s/ Anne-Mari Paster* | ||
Anne-Mari Paster |
CUSIP NO. 02083G100 | 13G | Page 11 of 11 Pages |
Exhibit(s):
Exhibit 99.1: | Joint Filing Statement | |
Exhibit 99.2: | Power of Attorney |