Cindy Jacobs - Apr 28, 2022 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: Apr 28, 2022
Transactions value $: -$4,525
Form type: 4
Date filed: 4/29/2022, 04:43 PM
Previous filing: Jan 5, 2022
Next filing: Aug 18, 2022

Transactions Table

Type	Sym	Class	Transaction	Value $	Shares	Change %	* Price $	Shares After	Date	Ownership	Footnotes
transaction	ACHV	Common Stock	Options Exercise	$0	+2.5K	+1121.08%	$0.00	2.72K	Apr 28, 2022	Direct	F1
transaction	ACHV	Common Stock	Tax liability	-$4.52K	-609	-22.37%	$7.43	2.11K	Apr 28, 2022	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	Performance Restricted Stock Unit (PRSU)	Options Exercise	$0	-2.5K	-50%	$0.00	2.5K	Apr 28, 2022	Common Stock	2.5K		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 performance restricted stock units ("PRSUs") 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 PRSUs.
F3	Each PRSU represents a contingent right to receive one share of the issuer's common stock at settlement.
F4	Pursuant to the terms of the PRSU 50% of the total shares underlying the PRSU vest on the achievement of a performance-based milestone, and 50% vest on the first anniversary of the achievement of such milestone.