0001209191-23-025536.txt : 20230425
0001209191-23-025536.hdr.sgml : 20230425
20230425162857
ACCESSION NUMBER: 0001209191-23-025536
CONFORMED SUBMISSION TYPE: 4/A
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230421
FILED AS OF DATE: 20230425
DATE AS OF CHANGE: 20230425
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Bencich John
CENTRAL INDEX KEY: 0001477056
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 033-80623
FILM NUMBER: 23845246
MAIL ADDRESS:
STREET 1: 2401 FOURTH AVENUE, SUITE 1050
CITY: SEATTLE
STATE: WA
ZIP: 98121
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/A
1
doc4a.xml
FORM 4/A SUBMISSION
X0407
4/A
2023-04-21
2023-04-24
0
0000949858
ACHIEVE LIFE SCIENCES, INC.
ACHV
0001477056
Bencich John
22722 29TH DR SE
SUITE 100
BOTHELL
WA
98021
1
1
0
0
CEO
0
Common Stock
2023-04-21
4
F
0
5863
6.80
D
56057
D
This amended Form 4 is filed to correct an administrative error which applied additional taxes and misreported the number of shares of common stock withheld by the issuer to satisfy the tax liability in connection with the settlement of performance restricted stock units. 5,863 shares were withheld instead of 7,324.
The number of shares beneficially owned by the reporting person increased from 54,596 shares to 56,075 shares.
Sandra Thomson as attorney-in-fact for John Bencich
2023-04-25