ACHIEVE LIFE SCIENCES, INC. — Director's Dealing 2022

Nov 21, 2022

SEC Form 4 — Statement of Changes in Beneficial Ownership

Issuer: ACHIEVE LIFE SCIENCES, INC. (ACHV)
CIK: 0000949858
Period of Report: 2022-11-18

Reporting Person: Bencich John (Director, CEO)

Non-Derivative Transactions

Date	Security	Code	Shares	Price	A/D	Holdings After	Ownership
2022-11-18	Common Stock	P	22000	—	Acquired	36920	Direct

Derivative Transactions

Date	Security	Exercise Price	Code	Shares	A/D	Expiration	Underlying	Ownership
2022-11-18	Common Stock Warrants (right to buy)	$4.50	P	11000	Acquired	2029-11-18	Common Stock (11000)	Direct

Footnotes

F1: The unregistered shares reported on this Form 4 were purchased in a private placement as part of a unit. Each unit consists of (i) two shares of the Issuer's common stock, and (ii) a warrant to purchase one share of common stock, at a purchase price of $4.625 per unit. The warrants are exercisable at a price per share of common stock of $4.50.