0001209191-17-052399.txt : 20170912 0001209191-17-052399.hdr.sgml : 20170912 20170912151515 ACCESSION NUMBER: 0001209191-17-052399 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170801 FILED AS OF DATE: 20170912 DATE AS OF CHANGE: 20170912 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MOYES JAY M CENTRAL INDEX KEY: 0001191062 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 033-80623 FILM NUMBER: 171080964 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ACHIEVE LIFE SCIENCES, INC. CENTRAL INDEX KEY: 0000949858 STANDARD INDUSTRIAL CLASSIFICATION: IN VITRO & IN VIVO DIAGNOSTIC SUBSTANCES [2835] IRS NUMBER: 954343413 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 19820 NORTH CREEK PARKWAY STREET 2: SUITE 201 CITY: BOTHELL STATE: WA ZIP: 98011 BUSINESS PHONE: 425-686-1500 MAIL ADDRESS: STREET 1: 19820 NORTH CREEK PARKWAY STREET 2: SUITE 201 CITY: BOTHELL STATE: WA ZIP: 98011 FORMER COMPANY: FORMER CONFORMED NAME: ONCOGENEX PHARMACEUTICALS, INC. DATE OF NAME CHANGE: 20080821 FORMER COMPANY: FORMER CONFORMED NAME: SONUS PHARMACEUTICALS INC DATE OF NAME CHANGE: 19950825 4/A 1 doc4a.xml FORM 4/A SUBMISSION X0306 4/A 2017-08-01 2017-08-03 0 0000949858 ACHIEVE LIFE SCIENCES, INC. ACHV 0001191062 MOYES JAY M 19820 NORTH CREEK PARKWAY SUITE 201 BOTHELL WA 98011 1 0 0 0 Stock Option (right to buy) 2.89 2017-08-01 4 A 0 16400 0.00 A 2027-08-01 Common Stock 16400 16400 D This 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. The options vest in monthly installments over 36 months commencing one month from August 1, 2017. Sandra Thomson as attorney-in-fact for Jay Moyes 2017-09-12