Mark Lawrence Rubinstein - 28 Jan 2025 Form 4 Insider Report for ACHIEVE LIFE SCIENCES, INC. (ACHV)

Role
Chief Medical Officer
Signature
Sandra Thomson as attorney-in-fact for Mark Rubinstein
Issuer symbol
ACHV
Transactions as of
28 Jan 2025
Net transactions value
$0
Form type
4
Filing time
30 Jan 2026, 16:10:02 UTC
Next filing
12 Jan 2026
SEC
View on sec.gov

Reporting Owners (1)

Name Relationship Address Signature Signature date CIK
Rubinstein Mark Lawrence Chief Medical Officer 22722 29TH DR. SE, SUITE 100, BOTHELL Sandra Thomson as attorney-in-fact for Mark Rubinstein 30 Jan 2025 0002103809

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Underlying Class Amount Exercise Price Ownership Footnotes
transaction ACHV Stock Option (right to buy) Award $0 +180,000 $0.000000 180,000 28 Jan 2026 Common Stock 180,000 $4.36 Direct F1
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 The option will vest as to 1/4 of the total award on the first anniversary of January 28, 2026, and thereafter in substantially equal monthly installments over 36 months, subject to the Reporting Person's provision of service to the Issuer on each vesting date.