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ACHIEVE LIFE SCIENCES, INC. Director's Dealing 2017

Aug 3, 2017

33882_dirs_2017-08-03_7757e5c9-c9e9-4c79-bf9e-aed3df350c02.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: Cormack Scott Daniel (Director)

Non-Derivative Transactions

Date Security Code Shares Price A/D Holdings After Ownership
2017-08-01 Common Stock M 3125 $0.00 Acquired 16302 Direct
2017-08-01 Common Stock M 1590 $0.00 Acquired 9685 Indirect

Derivative Transactions

Date Security Exercise Price Code Shares A/D Expiration Underlying Ownership
2017-08-01 Restricted Stock Unit (RSU) $ M 568 Disposed 2018-04-13 Common Stock (568) Direct
2017-08-01 Restricted Stock Unit (RSU) $ M 1705 Disposed 2019-06-18 Common Stock (1705) Direct
2017-08-01 Restricted Stock Unit (RSU) $ M 852 Disposed 2018-06-12 Common Stock (852) Direct
2017-08-01 Restricted Stock Unit (RSU) $ M 284 Disposed 2018-04-13 Common Stock (284) Indirect
2017-08-01 Restricted Stock Unit (RSU) $ M 852 Disposed 2019-06-18 Common Stock (852) Indirect
2017-08-01 Restricted Stock Unit (RSU) $ M 454 Disposed 2018-06-12 Common Stock (454) Indirect
2017-08-01 Stock Option (right to buy) $4.57 A 11000 Acquired 2027-08-01 Common Stock (11000) Direct

Holdings (Derivative)

Security Exercise Price Expiration Underlying Shares Ownership
Stock Option (right to buy) $245.08 2019-12-31 Common Stock (2272) 2272 Direct
Stock Option (right to buy) $175.67 2020-12-14 Common Stock (3636) 3636 Direct
Stock Option (right to buy) $143.00 2022-05-08 Common Stock (3409) 3409 Direct
Stock Option (right to buy) $131.45 2023-03-12 Common Stock (3409) 3409 Direct
Stock Option (right to buy) $129.69 2024-03-14 Common Stock (4545) 4545 Direct
Stock Option (right to buy) $20.46 2025-05-19 Common Stock (6818) 6818 Direct
Stock Option (right to buy) $156.20 2020-06-08 Common Stock (318) 318 Indirect
Stock Option (right to buy) $185.13 2021-01-03 Common Stock (3181) 3181 Indirect
Stock Option (right to buy) $143.00 2022-05-08 Common Stock (1363) 1363 Indirect
Stock Option (right to buy) $131.45 2023-03-12 Common Stock (1818) 1818 Indirect
Stock Option (right to buy) $129.69 2024-03-14 Common Stock (2272) 2272 Indirect
Stock Option (right to buy) $20.46 2015-05-19 Common Stock (3409) 3409 Indirect

Footnotes

F1: Represents shares of common stock acquired upon settlement of the restricted stock units ("RSUs") listed in Table II. On August 1, 2017, the effective date of the merger between OncoGenex Pharmaceuticals, Inc. and Achieve Life Science, Inc. (the "Merger"), the closing price of Achieve Life Sciences, Inc.'s common stock was $4.576 per share, representing a closing price of $0.416 per share of Oncogenex common stock as adjusted to reflect an 11-to-1 reverse stock split effected on August 1, 2017 (the "Reverse Stock Split").

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 reporting holder's employment agreement, the RSUs immediately vested in full on August 1, 2017, in connection with the consummation of the Merger.

F4: Reflects the Reverse Stock Split.

F5: Pursuant to the terms of the reporting holder's spouse's consulting agreement, the RSU immediately vested on August 1, 2017, in connection with the consummation of the Merger.