CINDY JACOBS - 25 Jan 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
Issuer symbol
ACHV
Transactions as of
25 Jan 2023
Net transactions value
$0
Form type
4
Filing time
27 Jan 2023, 15:47:26 UTC
Previous filing
18 Aug 2022
Next filing
25 Apr 2023
SEC
View on sec.gov

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 +60,000 $0.000000 60,000 25 Jan 2023 Common Stock 60,000 Direct F1, F2
transaction ACHV Stock Option (right to buy) Award $0 +60,000 $0.000000 60,000 25 Jan 2023 Common Stock 60,000 $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.