ACHIEVE LIFE SCIENCES, INC. — Director's Dealing 2020

Aug 19, 2020

SEC Form 4 — Statement of Changes in Beneficial Ownership

Issuer: ACHIEVE LIFE SCIENCES, INC. (ACHV)
CIK: 0000949858
Period of Report: 2020-08-18

Reporting Person: JACOBS CINDY (EVP, CMO)

Non-Derivative Transactions

Date	Security	Code	Shares	Price	A/D	Holdings After	Ownership
2020-08-18	Common Stock	M	69	$0.00	Acquired	209	Direct
2020-08-18	Common Stock	F	33	$8.95	Disposed	176	Direct

Derivative Transactions

Date	Security	Exercise Price	Code	Shares	A/D	Expiration	Underlying	Ownership
2020-08-18	Restricted Stock Unit (RSU)	$	M	69	Disposed	2021-08-01	Common Stock (69)	Direct

Footnotes

F1: Represents shares of common stock acquired upon settlement of the restricted stock units ("RSUs") listed in Table II.

F2: On July 31, 2020, the Issuer effected a 1-for-20 split of its common stock (the "Stock Split") resulting in a decrease of the reporting person's ownership by 2,661 shares of common stock.

F3: Represents shares of common stock that have been sold by the Issuer to satisfy its income tax withholding and remittance obligations in connection with the net settlement of the RSUs and does not represent a sale by the reporting person.

F4: Each RSU represents a contingent right to receive one share of the issuer's common stock at settlement.

F5: This RSU was initially reported as covering 54,800 shares and was adjusted on May 23, 2018 to reflect a 1-for-10 split, and which number has been adjusted to reflect the Stock Split.

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 1, 2017 and (ii) the first day thereafter during which the issuer's trading window is open.