Cindy Jacobs - Jan 25, 2023 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
Jan 25, 2023
Transactions value $
$0
Form type
4
Date filed
1/27/2023, 03:47 PM
Previous filing
Aug 18, 2022
Next filing
Apr 25, 2023

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) Award $0 +60K $0.00 60K Jan 25, 2023 Common Stock 60K Direct F1, F2
transaction ACHV Stock Option (right to buy) Award $0 +60K $0.00 60K Jan 25, 2023 Common Stock 60K $4.90 Direct F3
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 Each PRSU represents a contingent right to receive one share of the issuer's common stock at settlement.
F2 Pursuant to the terms of the award agreement governing the PRSU, the number of underlying shares of the Issuers common stock that may ultimately vest range from 0% to 100% of the number of PRSUs initially granted, subject to certain milestones being met during the measurement period that begins on January 3, 2023 and ends on December 31, 2025.
F3 The options vest one-third on the first anniversary of January 25, 2023 and thereafter in monthly installments over 24 months.