SEC Form 4 · accession 0001209191-15-077353
ACHIEVE LIFE SCIENCES, INC. · ACHV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Neil James Clendeninn
Director
Period of report
Oct 28, 2015
Accepted (ET)
Oct 30, 2015 · 11:23 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 Stock | Oct 28, 2015 | M | 5,359 | $2.69 | A | 19,921 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (right to buy) | $2.69 | Oct 28, 2015 | M | 5,359 | D | Oct 28, 2008 | Oct 28, 2015 | Common Stock | 5,359 | 0 | D |