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ACHIEVE LIFE SCIENCES, INC. Director's Dealing 2017

Aug 3, 2017

33882_dirs_2017-08-03_dd4ef000-9807-4e02-9b8c-2443f03dcc40.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: JACOBS CINDY (EVP, CMO)

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 7975 Direct

Holdings (Derivative)

Security Exercise Price Expiration Underlying Shares Ownership
Stock Option (right to buy) $245.08 2019-12-31 Common Stock (1090) 1090 Direct
Stock Option (right to buy) $175.67 2020-12-14 Common Stock (1818) 1818 Direct
Stock Option (right to buy) $143.00 2022-05-08 Common Stock (1363) 1363 Direct
Stock Option (right to buy) $131.45 2023-03-12 Common Stock (1818) 1818 Direct
Stock Option (right to buy) $129.69 2024-03-14 Common Stock (2272) 2272 Direct
Stock Option (right to buy) $20.46 2025-05-19 Common Stock (3409) 3409 Direct
Restricted Stock Unit (RSU) $ 2018-04-01 Common Stock (284) 284 Direct
Restricted Stock Unit (RSU) $ 2018-06-12 Common Stock (454) 454 Direct
Restricted Stock Unit (RSU) $ 2019-05-19 Common Stock (852) 852 Direct

Footnotes

F1: Reflects the 11-for-1 reverse stock split effected on August 1, 2017 immediately following the merger between OncoGenex Pharmaceuticals, Inc. and Achieve Life Science, Inc.

F2: Each 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 RSUs expire 30 days from the date they vest.

F5: The options vest as to 25% on August 1, 2018 and thereafter in monthly installments over 36 months.

F6: The options are fully vested and exercisable.

F7: The options vest in monthly installments over 48 months commencing one month from January 1, 2014.

F8: The options vest in monthly installments over 48 months commencing one month from January 1, 2015.

F9: 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, 2014 and (ii) the first day thereafter during which the issuer's trading window is open.

F10: 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 June 12, 2014 and (ii) the first day thereafter during which the issuer's trading window is open.

F11: 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.