Form 4 for ACHV ACHIEVE LIFE SCIENCES, INC.

Accepted 2022-11-21 00:00:00 ET · period of report 2022-11-18 · accession 0001209191-22-058064 · SEC index · Original document

Summary rows

Aggregated the way they appear in lists: one row per insider, transaction code and security table.

X	Filed	Traded	Ticker	Insider	Title	Type	Price	Qty	Owned	ΔOwn	Value
D	2022-11-21	2022-11-18	ACHV	Bencich John	CEO, Dir	P - Purchase	—	+22.0K	36.9K	+147%	—
D	2022-11-21	2022-11-18	ACHV	Bencich John	CEO, Dir	P - Purchase	—	+11.0K	11.0K	New	—

Purchase Sale Sale after option exercise All abbreviations

#	Table	Security	Date	Code	A/D	Shares	Price	Owned after	Own	Exercise / expiry	Underlying	Footnotes
1	Common	Common Stock	2022-11-18	P	A	22,000	—	36,920	D	—	—	(F1) The unregistered shares reported on this Form 4 were purchased in a private placement as part of a unit. Each unit consists of (i) two shares of the Issuer's common stock, and (ii) a warrant to purchase one share of common stock, at a purchase price of $4.625 per unit. The warrants are exercisable at a price per share of common stock of $4.50.
2	Derivative	Common Stock Warrants (right to buy)	2022-11-18	P	A	11,000	—	11,000	D	$4.50 · 2023-05-18 to 2029-11-18	11,000 Common Stock	(F1) The unregistered shares reported on this Form 4 were purchased in a private placement as part of a unit. Each unit consists of (i) two shares of the Issuer's common stock, and (ii) a warrant to purchase one share of common stock, at a purchase price of $4.625 per unit. The warrants are exercisable at a price per share of common stock of $4.50.