0001209191-23-035786.txt : 20230609
0001209191-23-035786.hdr.sgml : 20230609
20230609161539
ACCESSION NUMBER: 0001209191-23-035786
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230329
FILED AS OF DATE: 20230609
DATE AS OF CHANGE: 20230609
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Sellig Thomas
CENTRAL INDEX KEY: 0001969416
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 033-80623
FILM NUMBER: 231005469
MAIL ADDRESS:
STREET 1: 22722 29TH DR 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: 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
2023-03-29
0
0000949858
ACHIEVE LIFE SCIENCES, INC.
ACHV
0001969416
Sellig Thomas
22722 29TH DR SE
SUITE 100
BOTHELL
WA
98021
1
0
0
0
0
Stock Option (right to buy)
5.97
2023-03-29
4
A
0
23250
0.00
A
2033-03-29
Common Stock
23250
23250
D
These options were granted on March 29, 2023 (the "Grant Date") pursuant to the 2023 Non-Employee Director Equity Incentive Plan (the "Plan"), subject to the Plans approval by the Issuers stockholders. The Plan was approved by the Issuers stockholders at the Issuers 2023 Annual Meeting of Stockholders on June 7, 2023. These options will vest on the one month anniversary of the Grant Date and thereafter in monthly installments over 36 months.
Sandra Thomson attorney-in-fact for Thomas Sellig
2023-06-09