SEC Form 4 · accession 0001209191-15-045787
ACHIEVE LIFE SCIENCES, INC. · ACHV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Martin A Mattingly
Director
Period of report
May 20, 2015
Accepted (ET)
May 22, 2015 · 9:35 am EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000949858
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | May 20, 2015 | M | 2,500 | — | A | 8,000 | D |
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)F3,F4 | — | May 20, 2015 | M | 2,500 | D | May 20, 2015 | — | Common Stock | 2,500 | 0 | D |
| Stock Option (right to buy)F5 | $1.89 | May 21, 2015 | A | 5,000 | A | — | May 21, 2025 | Common Stock | 5,000 | 5,000 | D |
| Restricted Stock Unit (RSU)F3,F6,F4 | — | May 21, 2015 | A | 2,500 | A | — | — | Common Stock | 2,500 | 2,500 | D |
Explanation of responses
- F1Represents shares of common stock acquired upon settlement of the restricted stock units ("RSUs") listed in Table II.
- F2RSUs convert into common stock on a one-for-one basis.
- F3Each RSU represents a contingent right to receive one share of the issuer's common stock.
- F4The RSUs expire 30 days from the date they vest.
- F5The options vest 100% on the earlier of May 21, 2016 or the date immediately prior to the issuer's next annual meeting of stockholders.
- F6The RSUs vest 100% on the earlier of the first anniversary of the grant date or the date immediately prior to the issuer's next annual meeting of stockholders, if this date is when the issuer's trading window is closed, it will vest the first day thereafter during which the issuer's trading window is open.