0001209191-22-033132.txt : 20220601 0001209191-22-033132.hdr.sgml : 20220601 20220601160741 ACCESSION NUMBER: 0001209191-22-033132 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220531 FILED AS OF DATE: 20220601 DATE AS OF CHANGE: 20220601 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MOYES JAY M CENTRAL INDEX KEY: 0001191062 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 033-80623 FILM NUMBER: 22987379 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: 22722 29TH DR. SE STREET 2: SUITE 100 CITY: SEATTLE STATE: WA ZIP: 98021 BUSINESS PHONE: 425-686-1500 MAIL ADDRESS: STREET 1: 22722 29TH DR. SE STREET 2: SUITE 100 CITY: SEATTLE STATE: WA ZIP: 98021 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 1 doc4.xml FORM 4 SUBMISSION X0306 4 2022-05-31 0 0000949858 ACHIEVE LIFE SCIENCES, INC. ACHV 0001191062 MOYES JAY M 22722 29TH DR SE SUITE 100 BOTHELL WA 98021 1 0 0 0 Stock Option (right to buy) 6.90 2022-05-31 4 A 0 4400 0.00 A 2032-05-31 Common Stock 4400 4400 D The options vest 100% on the earlier of May 31, 2023 or the date immediately prior to the Issuer's next annual meeting of stockholders. Sandra Thomson as attorney-in-fact for Jay Moyes 2022-06-01