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ACHIEVE LIFE SCIENCES, INC. Director's Dealing 2017

Aug 3, 2017

33882_dirs_2017-08-03_0bb4565a-0881-4e90-9d8a-a1b2dbbce2de.zip

Director's Dealing

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SEC Form 4 — Statement of Changes in Beneficial Ownership

Issuer: ACHIEVE LIFE SCIENCES, INC. (ACHV)
CIK: 0000949858
Period of Report: 2017-08-01

Reporting Person: Bencich John (CFO)

Derivative Transactions

Date Security Exercise Price Code Shares A/D Expiration Underlying Ownership
2017-08-01 Restricted Stock Unit (RSU) $ A 54800 Acquired 2021-08-01 Common Stock (54800) Direct
2017-08-01 Stock Option (right to buy) $4.57 A 274000 Acquired 2027-08-01 Common Stock (274000) Direct

Holdings (Non-Derivative)

Security Shares Ownership
Common Stock 1053 Direct

Holdings (Derivative)

Security Exercise Price Expiration Underlying Shares Ownership
Stock Option (right to buy) $34.87 2024-08-12 Common Stock (3636) 3636 Direct
Restricted Stock Unit (RSU) $ 2018-08-12 Common Stock (909) 909 Direct
Stock Option (right to buy) $20.46 2025-05-19 Common Stock (2272) 2272 Direct
Restricted Stock Unit (RSU) $ 2019-05-19 Common Stock (568) 568 Direct

Footnotes

F1: Reflects the 1-for-11 reverse stock split following the merger between OncoGenex Pharmaceuticals, Inc. and Achieve Life Science, Inc.

F2: Each restricted stock unit ("RSU") represents a contingent right to receive one share of the issuer's common stock at settlement.

F3: Pursuant to the terms of the RSU, 25% of the total shares underlying the RSU vest annually on the later of (i) each anniversary of August 1, 2017 and (ii) the first day thereafter during which the issuer's trading window is open.

F4: The options vest as to 25% on August 1, 2018 and thereafter in monthly installments over 36 months.

F5: The options vest in monthly installments over 48 months commencing one month from August 12, 2014.

F6: Pursuant to the terms of the RSU, 25% of the total shares underlying the RSU vest annually on the later of (i) each anniversary of August 12, 2014 and (ii) the first day thereafter during which the issuer's trading window is open.

F7: The options vest in monthly installments over 48 months commencing one month from January 1, 2015

F8: Pursuant to the terms of the RSU, 25% of the total shares underlying the RSU vest annually on the later of (i) each anniversary of January 1, 2015 and (ii) the first day thereafter during which the issuer's trading window is open.