ACHIEVE LIFE SCIENCES, INC. — Director's Dealing 2023

Jan 27, 2023

SEC Form 4 — Statement of Changes in Beneficial Ownership

Issuer: ACHIEVE LIFE SCIENCES, INC. (ACHV)
CIK: 0000949858
Period of Report: 2023-01-25

Reporting Person: Bencich John (Director, CEO)

Derivative Transactions

Date	Security	Exercise Price	Code	Shares	A/D	Expiration	Underlying	Ownership
2023-01-25	Performance Restricted Stock Unit (PRSU)	$	A	100000	Acquired	2025-12-31	Common Stock (100000)	Direct
2023-01-25	Stock Option (right to buy)	$4.90	A	100000	Acquired	2033-01-25	Common Stock (100000)	Direct

Footnotes

F1: Each PRSU represents a contingent right to receive one share of the issuer's common stock at settlement.

F2: Pursuant to the terms of the award agreement governing the PRSU, the number of underlying shares of the Issuers common stock that may ultimately vest range from 0% to 100% of the number of PRSUs initially granted, subject to certain milestones being met during the measurement period that begins on January 3, 2023 and ends on December 31, 2025.

F3: The options vest one-third on the first anniversary of January 25, 2023 and thereafter in monthly installments over 24 months.