0001209191-23-025383.txt : 20230424 0001209191-23-025383.hdr.sgml : 20230424 20230424161556 ACCESSION NUMBER: 0001209191-23-025383 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230421 FILED AS OF DATE: 20230424 DATE AS OF CHANGE: 20230424 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Stewart Richard Alistair CENTRAL INDEX KEY: 0001713369 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 033-80623 FILM NUMBER: 23840286 BUSINESS ADDRESS: BUSINESS PHONE: 6046305411 MAIL ADDRESS: STREET 1: 19820 NORTH CREEK PARKWAY STREET 2: SUITE 201 CITY: BOTHELL STATE: WA ZIP: 98011 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 X0407 4 2023-04-21 0 0000949858 ACHIEVE LIFE SCIENCES, INC. ACHV 0001713369 Stewart Richard Alistair 22722 29TH DR SE SUITE 100 BOTHELL WA 98021 1 1 0 0 Executive Chairman 0 Common Stock 2023-04-21 4 M 0 22500 0.00 A 35876 D Common Stock 2023-04-21 4 F 0 10125 6.80 D 25751 D Common Stock 359 I By Spouse Common Stock 882 I By Ricanto Limited Performance Restricted Stock Unit (PRSU) 2023-04-21 4 M 0 22500 0.00 A 2026-01-03 Common Stock 22500 22500 D Represents shares of common stock acquired upon settlement of the performance restricted stock units ("PRSUs") listed in Table II. Represents shares of common stock that have been withheld by the issuer to satisfy the tax liability in connection with the settlement of PRSUs. The reporting holder is a principal owner of Ricanto Limited. Each PRSU represents a contingent right to receive one share of the issuer's common stock at settlement. Pursuant to the terms of the PRSU 50% of the total shares underlying the PRSU vest on the achievement of a performance-based milestone, and 50% vest on the first anniversary of the achievement of such milestone. Sandra Thomson as attorney-in-fact for Richard Stewart 2023-04-24