SEC Form 4 · accession 0001209191-17-047582
ACHIEVE LIFE SCIENCES, INC. · ACHV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
A later amendment supersedes this filing — read the amendment. The figures below are kept as originally reported (version chain, not an overwrite).
Reporting owner
Anthony Clarke
Officer — Chief Scientific Officer · Director
Period of report
Aug 1, 2017
Accepted (ET)
Aug 3, 2017 · 8:46 pm 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 | Aug 1, 2017 | A | 6,364,335 | — | A | 6,364,335 | D | |
| Common StockF2 | Aug 1, 2017 | A | 4,242,890 | — | A | 4,242,890 | I | By Spouse |
| Common StockF1 | Aug 1, 2017 | A | 6,364,335 | — | A | 6,364,335 | I | By Son |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Received in exchange for 1,500 common shares of Achieve Life Science, Inc. ("Achieve") pursuant to the merger between OncoGenex Pharmaceuticals, Inc. ("OncoGenex") and Achieve (the "Merger"). On the effective date of the Merger, the closing price of Achieve's common stock was $4.576 per share, representing a closing price of $0.416 per share of OncoGenex's common stock as adjusted to reflect an 11-for-1 reverse stock split effected on August 1, 2017 (the "Reverse Stock Split").
- F2Received in exchange for 1,000 common shares of Achieve pursuant to the Merger between OncoGenex and Achieve. On the effective date of the Merger, the closing price of Achieve's common stock was $4.576 per share, representing a closing price of $0.416 per share of OncoGenex's common stock as adjusted to reflect the Reverse Stock Split.