SEC Form 4 · accession 0001209191-15-045580
ACHIEVE LIFE SCIENCES, INC. · ACHV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
John Bencich
Officer — CFO
Period of report
May 19, 2015
Accepted (ET)
May 21, 2015 · 6:27 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000949858
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Restricted Stock Unit (RSU)F1,F2 | — | May 19, 2015 | A | 12,500 | A | — | Jun 18, 2019 | Common Stock | 12,500 | 12,500 | D |
| Stock Option (right to buy)F3 | $1.86 | May 19, 2015 | A | 25,000 | A | — | May 19, 2025 | Common Stock | 25,000 | 25,000 | D |
Explanation of responses
- F1Each restricted stock unit (RSU) represents a contingent right to receive one share of the issuer's common stock at settlement.
- F2Pursuant to the terms of the RSU, 25% of the total shares underlying the RSU vest annually on the later of: (i) each anniversary of January 1, 2015; and (ii) the first day thereafter during which the issuer's trading window is open.
- F3The options vest in monthly installments over 48 months commencing one month from January 1, 2015