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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Restricted Stock Unit (RSU) | (2) | 08/01/2017 | M | 568 | (3) | 04/13/2018 | Common Stock | 568 (4) | $ 0 | 0 | D | ||||
Restricted Stock Unit (RSU) | (2) | 08/01/2017 | M | 1,705 | (3) | 06/18/2019 | Common Stock | 1,705 (4) | $ 0 | 0 | D | ||||
Restricted Stock Unit (RSU) | (2) | 08/01/2017 | M | 852 | (3) | 06/12/2018 | Common Stock | 852 (4) | $ 0 | 0 | D | ||||
Restricted Stock Unit (RSU) | (2) | 08/01/2017 | M | 284 | (5) | 04/13/2018 | Common Stock | 284 (4) | $ 0 | 0 | I | By Spouse | |||
Restricted Stock Unit (RSU) | (2) | 08/01/2017 | M | 852 | (5) | 06/18/2019 | Common Stock | 852 (4) | $ 0 | 0 | I | By Spouse | |||
Restricted Stock Unit (RSU) | (2) | 08/01/2017 | M | 454 | (5) | 06/12/2018 | Common Stock | 454 (4) | $ 0 | 0 | I | By Spouse | |||
Stock Option (right to buy) | $ 4.57 | 08/01/2017 | A | 11,000 | 08/01/2018 | 08/01/2027 | Common Stock | 11,000 | $ 0 | 11,000 | D | ||||
Stock Option (right to buy) | $ 245.08 (4) | (3) | 12/31/2019 | Common Stock | 2,272 (4) | 2,272 | D | ||||||||
Stock Option (right to buy) | $ 175.67 (4) | (3) | 12/14/2020 | Common Stock | 3,636 (4) | 3,636 | D | ||||||||
Stock Option (right to buy) | $ 143 (4) | (3) | 05/08/2022 | Common Stock | 3,409 (4) | 3,409 | D | ||||||||
Stock Option (right to buy) | $ 131.45 (4) | (3) | 03/12/2023 | Common Stock | 3,409 (4) | 3,409 | D | ||||||||
Stock Option (right to buy) | $ 129.69 (4) | (3) | 03/14/2024 | Common Stock | 4,545 (4) | 4,545 | D | ||||||||
Stock Option (right to buy) | $ 20.46 (4) | (3) | 05/19/2025 | Common Stock | 6,818 (4) | 6,818 | D | ||||||||
Stock Option (right to buy) | $ 156.2 (4) | (5) | 06/08/2020 | Common Stock | 318 (4) | 318 | I | By Spouse | |||||||
Stock Option (right to buy) | $ 185.13 (4) | (5) | 01/03/2021 | Common Stock | 3,181 (4) | 3,181 | I | By Spouse | |||||||
Stock Option (right to buy) | $ 143 (4) | (5) | 05/08/2022 | Common Stock | 1,363 (4) | 1,363 | I | By Spouse | |||||||
Stock Option (right to buy) | $ 131.45 (4) | (5) | 03/12/2023 | Common Stock | 1,818 (4) | 1,818 | I | By Spouse | |||||||
Stock Option (right to buy) | $ 129.69 (4) | (4) | 03/14/2024 | Common Stock | 2,272 (4) | 2,272 | I | By Spouse | |||||||
Stock Option (right to buy) | $ 20.46 (4) | (5) | 05/19/2015 | Common Stock | 3,409 (4) | 3,409 | I | By Spouse |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Cormack Scott Daniel 19820 NORTH CREEK PARKWAY SUITE 201 BOTHELL, WA 98011 |
X |
Sandra Thomson as attorney-in-fact for Scott Cormack | 08/03/2017 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | Represents shares of common stock acquired upon settlement of the restricted stock units ("RSUs") listed in Table II. On August 1, 2017, the effective date of the merger between OncoGenex Pharmaceuticals, Inc. and Achieve Life Science, Inc. (the "Merger"), the closing price of Achieve Life Sciences, Inc.'s common stock was $4.576 per share, representing a closing price of $0.416 per share of Oncogenex common stock as adjusted to reflect an 11-to-1 reverse stock split effected on August 1, 2017 (the "Reverse Stock Split"). |
(2) | Each RSU represents a contingent right to receive one share of the issuer's common stock at settlement. |
(3) | Pursuant to the terms of the reporting holder's employment agreement, the RSUs immediately vested in full on August 1, 2017, in connection with the consummation of the Merger. |
(4) | Reflects the Reverse Stock Split. |
(5) | Pursuant to the terms of the reporting holder's spouse's consulting agreement, the RSU immediately vested on August 1, 2017, in connection with the consummation of the Merger. |