John Bencich - 28 Apr 2023 Form 4 Insider Report for ACHIEVE LIFE SCIENCES, INC. (ACHV)

Role: CEO, Director
Signature: Sandra Thomson as attorney-in-fact for John Bencich
Issuer symbol: ACHV
Transactions as of: 28 Apr 2023
Net transactions value: -$15,146
Form type: 4
Filing time: 01 May 2023, 17:53:03 UTC
Previous filing: 25 Apr 2023
Next filing: 01 Jun 2023
SEC: View on sec.gov

Transactions Table

Type	Sym	Class	Transaction	Value $	Shares	Change %	* Price $	Shares After	Date	Ownership	Footnotes
transaction	ACHV	Common Stock	Options Exercise	$0	+7,500	+13%	$0.000000	63,557	28 Apr 2023	Direct	F1
transaction	ACHV	Common Stock	Tax liability	$15,146	-1,827	-2.9%	$8.29	61,730	28 Apr 2023	Direct	F2

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type	Sym	Class	Transaction	Value $	Shares	Change %	* Price $	Shares After	Date	Underlying Class	Amount	Exercise Price	Ownership	Footnotes
transaction	ACHV	Performance Restricted Stock Unit (PRSU)	Options Exercise	$0	-7,500	-100%	$0.000000^*	0	28 Apr 2023	Common Stock	7,500		Direct	F3, F4

* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id	Content
F1	Represents shares of common stock acquired upon settlement of the performance restricted stock units ("PRSUs") listed in Table II.
F2	Represents shares of common stock that have been withheld by the issuer to satisfy the tax liability in connection with the settlement of PRSUs.
F3	Each PRSU represents a contingent right to receive one share of the issuer's common stock at settlement.
F4	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.