Cindy Jacobs - Aug 17, 2021 Form 4 Insider Report for ACHIEVE LIFE SCIENCES, INC. (ACHV)

Role: President & CMO, Director
Signature: Sandra Thomson as attorney-in-fact for Cindy Jacobs
Stock symbol: ACHV
Transactions as of: Aug 17, 2021
Transactions value $: -$143
Form type: 4
Date filed: 8/19/2021, 05:09 PM
Next filing: Jan 5, 2022

Transactions Table

Type	Sym	Class	Transaction	Value $	Shares	Change %	* Price $	Shares After	Date	Ownership	Footnotes
transaction	ACHV	Common Stock	Options Exercise	$0	+68	+38.64%	$0.00	244	Aug 17, 2021	Direct	F1
transaction	ACHV	Common Stock	Tax liability	-$143	-21	-8.61%	$6.81	223	Aug 17, 2021	Direct	F2

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	Restricted Stock Unit (RSU)	Options Exercise	$0	-68	-100%	$0.00^*	0	Aug 17, 2021	Common Stock	68		Direct	F3, F4

* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id	Content
F1	Represents shares of common stock acquired upon settlement of the restricted stock units ("RSUs") listed in Table II.
F2	Represents shares of common stock that have been withheld by the issuer to satisfy the tax liability in connection with the settlement of RSUs.
F3	Each RSU represents a contingent right to receive one share of the issuer's common stock at settlement.
F4	Pursuant to the terms of the RSU, 25% of the total shares underlying the RSU vest annually on the later of (i) each anniversary of August 1, 2017 and (ii) the first day thereafter during which the issuer's trading window is open.