Jerry Wan - Apr 28, 2022 Form 4 Insider Report for ACHIEVE LIFE SCIENCES, INC. (ACHV)

Role
Principal Accounting Officer
Signature
Sandra Thomson as attorney-in-fact for Jerry Wan
Stock symbol
ACHV
Transactions as of
Apr 28, 2022
Transactions value $
-$4,971
Form type
4
Date filed
4/29/2022, 04:50 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 +1.25K +1329.79% $0.00 1.34K Apr 28, 2022 Direct F1
transaction ACHV Common Stock Tax liability -$4.97K -669 -49.78% $7.43 675 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 -1.25K -50% $0.00 1.25K Apr 28, 2022 Common Stock 1.25K 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.