0001209191-24-002207.txt : 20240124
0001209191-24-002207.hdr.sgml : 20240124
20240124192240
ACCESSION NUMBER: 0001209191-24-002207
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240122
FILED AS OF DATE: 20240124
DATE AS OF CHANGE: 20240124
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: KING THOMAS BRAXTON
CENTRAL INDEX KEY: 0001279309
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 033-80623
FILM NUMBER: 24558292
MAIL ADDRESS:
STREET 1: 91 JAMES AVENUE
CITY: ATHERTON
STATE: CA
ZIP: 94027
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: ACHIEVE LIFE SCIENCES, INC.
CENTRAL INDEX KEY: 0000949858
STANDARD INDUSTRIAL CLASSIFICATION: IN VITRO & IN VIVO DIAGNOSTIC SUBSTANCES [2835]
ORGANIZATION NAME: 03 Life Sciences
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
X0508
4
2024-01-22
0
0000949858
ACHIEVE LIFE SCIENCES, INC.
ACHV
0001279309
KING THOMAS BRAXTON
22722 29TH DR SE
SUITE 100
BOTHELL
WA
98021
1
0
0
0
0
Stock Option (right to buy)
4.55
2024-01-22
4
A
0
31500
0.00
A
2034-01-22
Common Stock
31500
31500
D
The options vest 100% on the earlier of 18 months from the grant date or the date immediately prior to the Issuer's 2025 annual meeting of stockholders.
Sandra Thomson as attorney-in-fact for Thomas B. King
2022-01-24