SEC Form 4/A · accession 0001209191-17-052375
ACHIEVE LIFE SCIENCES, INC. · ACHV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 4/A). It replaces an earlier filing for the same period.
Reporting owner
John Bencich
Officer — CFO
Period of report
Aug 1, 2017
Accepted (ET)
Sep 12, 2017 · 2:43 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,F2 | $2.89 | Aug 1, 2017 | A | 274,000 | A | — | Aug 1, 2027 | Common Stock | 274,000 | 274,000 | D |
Explanation of responses
- F1This amended Form 4 is filed to correct the exercise price to reflect that the grant was effective as of the issuer's first open trading window after approval of the grant. All other terms remain the same.
- F2The options vest as to 25% on August 1, 2018 and thereafter in monthly installments over 36 months.