0001209191-18-044358.txt : 20180730
0001209191-18-044358.hdr.sgml : 20180730
20180730155818
ACCESSION NUMBER: 0001209191-18-044358
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180726
FILED AS OF DATE: 20180730
DATE AS OF CHANGE: 20180730
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: JACOBS CINDY
CENTRAL INDEX KEY: 0001229762
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 033-80623
FILM NUMBER: 18977579
MAIL ADDRESS:
STREET 1: 1522 217TH PLACE SE
STREET 2: SUITE 100
CITY: BOTHELL
STATE: WA
ZIP: 98021
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: 520 PIKE STREET
STREET 2: SUITE 2250
CITY: SEATTLE
STATE: WA
ZIP: 98101
BUSINESS PHONE: 425-686-1500
MAIL ADDRESS:
STREET 1: 520 PIKE STREET
STREET 2: SUITE 2250
CITY: SEATTLE
STATE: WA
ZIP: 98101
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
2018-07-26
0
0000949858
ACHIEVE LIFE SCIENCES, INC.
ACHV
0001229762
JACOBS CINDY
520 PIKE STREET
SUITE 2250
SEATTLE
WA
98101
0
1
0
0
EVP, CMO
Stock Option (right to buy)
3.37
2018-07-26
4
A
0
20000
0.00
A
2028-07-26
Common Stock
20000
20000
D
The options vest in monthly installments over 48 months commencing one month from July 26 2018.
Sandra Thomson as attorney-in-fact for Cindy Jacobs
2018-07-30