Jerry Wan - 22 Jan 2024 Form 4 Insider Report for ACHIEVE LIFE SCIENCES, INC. (ACHV)

Role
Principal Accounting Officer
Signature
Sandra Thomson as attorney-in-fact for Jerry Wan
Issuer symbol
ACHV
Transactions as of
22 Jan 2024
Net transactions value
$0
Form type
4
Filing time
24 Jan 2024, 19:05:12 UTC
Previous filing
01 May 2023
Next filing
23 Apr 2024
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 +24,500 $0.000000 24,500 22 Jan 2024 Common Stock 24,500 Direct F1, F2
transaction ACHV Stock Option (right to buy) Award $0 +10,500 $0.000000 10,500 22 Jan 2024 Common Stock 10,500 $4.55 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 total number of shares underlying the PRSU vest on the achievement of one of certain milestones being met. The PRSUs will lapse in full if achievement of at least one of the milestones is not met.
F3 The options vest one-third on the first anniversary of January 22, 2024 and thereafter in monthly installments over 24 months.