SEC Form 4 · accession 0001209191-18-044358
ACHIEVE LIFE SCIENCES, INC. · ACHV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Cindy Jacobs
Officer — EVP, CMO
Period of report
Jul 26, 2018
Accepted (ET)
Jul 30, 2018 · 3:58 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 | $3.37 | Jul 26, 2018 | A | 20,000 | A | — | Jul 26, 2028 | Common Stock | 20,000 | 20,000 | D |
Explanation of responses
- F1The options vest in monthly installments over 48 months commencing one month from July 26 2018.