SEC Form 4 · accession 0001209191-16-123921
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
May 26, 2016
Accepted (ET)
May 27, 2016 · 1:55 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (right to buy)F1 | $1.00 | May 26, 2016 | A | 22,500 | A | — | May 26, 2026 | Common Stock | 22,500 | 22,500 | D |
Explanation of responses
- F1The options vest 100% on the earlier of May 26, 2017 or the date immediately prior to the issuer's next annual meeting of stockholders.