ACHIEVE LIFE SCIENCES, INC. — Director's Dealing 2024

Jan 24, 2024

SEC Form 4 — Statement of Changes in Beneficial Ownership

Issuer: ACHIEVE LIFE SCIENCES, INC. (ACHV)
CIK: 0000949858
Period of Report: 2024-01-22

Reporting Person: Bencich John (Director, CEO)

Derivative Transactions

Date	Security	Exercise Price	Code	Shares	A/D	Expiration	Underlying	Ownership
2024-01-22	Performance Restricted Stock Unit (PRSU)	$	A	175000	Acquired	2028-01-22	Common Stock (175000)	Direct
2024-01-22	Stock Option (right to buy)	$4.55	A	75000	Acquired	2034-01-22	Common Stock (75000)	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 total number of shares underlying the PRSU vest on the achievement of one of certain milestones being met. The PRSUs will lapse in full if achievement of at least one of the milestones is not met.

F3: The options vest one-third on the first anniversary of January 22, 2024 and thereafter in monthly installments over 24 months.