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SVB Financial Group, et al. – ‘4’ for 9/1/22 re: Achieve Life Sciences, Inc.

On:  Thursday, 9/1/22, at 4:05pm ET   ·   For:  9/1/22   ·   As:  10% Owner   ·   Accession #:  899243-22-30171   ·   File #:  33-80623

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  As Of               Filer                 Filing    For·On·As Docs:Size             Issuer                      Filing Agent

 9/01/22  SVB Financial Group               4          10% Owner   1:21K  Achieve Life Sciences, Inc.       Donnelley Fin’l S… 06/FA
          SVB Innovation Credit Fund VIII, L.P.
          SVB Innovation Credit Partners VIII, LLC
          Innovation Credit Fund VIII-A, L.P.
          SVB Innovation Credit Partners VIII-A, LLC

Statement of Changes in Beneficial Ownership of Securities by an Insider   —   Form 4   —   SEA’34

Filing Table of Contents

Document/Exhibit                   Description                      Pages   Size 

 1: 4           Form 4 Submission -- doc4.xml/3.6                   HTML     18K


        

This ‘4’ Document is an XML Data File that may be rendered in various formats:

  Form 4    –   Plain Text   –  SEC Website  –  EDGAR System  –    XML Data    –  <?xml?> File
 
 
Plain Text rendering:  Form 4 Submission
 
                                                                                                                                                                                
Ownership Document
 
Schema Version:  X0306
Document Type:  4
Period of Report:  9/1/22
Not Subject to Section 16:  0
Issuer:
Issuer CIK:  949858
Issuer Name:  ACHIEVE LIFE SCIENCES, INC.
Issuer Trading Symbol:  ACHV
Reporting Owner:
Reporting Owner ID:
Owner CIK:  719739
Owner Name:  SVB FINANCIAL GROUP
Reporting Owner Address:
Owner Street 1:  3003 TASMAN DRIVE
Owner Street 2:
Owner City:  SANTA CLARA
Owner State:  CA
Owner ZIP Code:  95054
Owner State Description:
Reporting Owner Relationship:
Is Director?  No
Is Officer?  No
Is Ten Percent Owner?  Yes
Is Other?  No
Reporting Owner:
Reporting Owner ID:
Owner CIK:  1901811
Owner Name:  SVB Innovation Credit Partners VIII, LLC
Reporting Owner Address:
Owner Street 1:  2770 SAND HILL ROAD
Owner Street 2:
Owner City:  MENLO PARK
Owner State:  CA
Owner ZIP Code:  94025
Owner State Description:
Reporting Owner Relationship:
Is Director?  No
Is Officer?  No
Is Ten Percent Owner?  Yes
Is Other?  No
Reporting Owner:
Reporting Owner ID:
Owner CIK:  1754832
Owner Name:  SVB Innovation Credit Fund VIII, L.P.
Reporting Owner Address:
Owner Street 1:  2770 SAND HILL ROAD
Owner Street 2:
Owner City:  MENLO PARK
Owner State:  CA
Owner ZIP Code:  94025
Owner State Description:
Reporting Owner Relationship:
Is Director?  No
Is Officer?  No
Is Ten Percent Owner?  Yes
Is Other?  No
Reporting Owner:
Reporting Owner ID:
Owner CIK:  1901800
Owner Name:  SVB Innovation Credit Partners VIII-A, LLC
Reporting Owner Address:
Owner Street 1:  2770 SAND HILL ROAD
Owner Street 2:
Owner City:  MENLO PARK
Owner State:  CA
Owner ZIP Code:  94025
Owner State Description:
Reporting Owner Relationship:
Is Director?  No
Is Officer?  No
Is Ten Percent Owner?  Yes
Is Other?  No
Reporting Owner:
Reporting Owner ID:
Owner CIK:  1864344
Owner Name:  Innovation Credit Fund VIII-A, L.P.
Reporting Owner Address:
Owner Street 1:  2770 SAND HILL ROAD
Owner Street 2:
Owner City:  MENLO PARK
Owner State:  CA
Owner ZIP Code:  94025
Owner State Description:
Reporting Owner Relationship:
Is Director?  No
Is Officer?  No
Is Ten Percent Owner?  Yes
Is Other?  No
Derivative Table:
Derivative Transaction:
Security Title:
Value:  Convertible Debt (PIK Amount)
Footnote ID:  F1
Footnote ID:  F2
Footnote ID:  F3
Footnote ID:  F4
Footnote ID:  F5
Conversion or Exercise Price:
Value:  9.34
Footnote ID:  F2
Footnote ID:  F3
Footnote ID:  F4
Transaction Date:
Value:  9/1/22
Deemed Execution Date:
Transaction Coding:
Transaction Form Type:  4
Transaction Code:  J
Equity Swap Involved?  No
Footnote ID:  F2
Footnote ID:  F3
Footnote ID:  F4
Footnote ID:  F5
Transaction Timeliness:
Value:
Transaction Amounts:
Transaction Total Value:
Value:  47,196.82
Transaction Price Per Share:
Footnote ID:  F2
Footnote ID:  F3
Footnote ID:  F4
Transaction Acquired-Disposed Code:
Value:  A
Exercise Date:
Footnote ID:  F2
Footnote ID:  F3
Footnote ID:  F4
Expiration Date:
Footnote ID:  F2
Footnote ID:  F3
Footnote ID:  F4
Underlying Security:
Underlying Security Title:
Value:  Common Stock
Underlying Security Shares:
Value:  5,053
Post-Transaction Amounts:
Value Owned Following Transaction:
Value:  7,877,084.65
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  See Footnotes
Footnote ID:  F6
Footnote ID:  F10
Derivative Transaction:
Security Title:
Value:  Convertible Debt (PIK Amount)
Footnote ID:  F1
Footnote ID:  F2
Footnote ID:  F3
Footnote ID:  F4
Footnote ID:  F5
Conversion or Exercise Price:
Value:  9.34
Footnote ID:  F2
Footnote ID:  F3
Footnote ID:  F4
Transaction Date:
Value:  9/1/22
Deemed Execution Date:
Transaction Coding:
Transaction Form Type:  4
Transaction Code:  J
Equity Swap Involved?  No
Footnote ID:  F2
Footnote ID:  F3
Footnote ID:  F4
Footnote ID:  F5
Transaction Timeliness:
Value:
Transaction Amounts:
Transaction Total Value:
Value:  23,598.41
Transaction Price Per Share:
Footnote ID:  F2
Footnote ID:  F3
Footnote ID:  F4
Transaction Acquired-Disposed Code:
Value:  A
Exercise Date:
Footnote ID:  F2
Footnote ID:  F3
Footnote ID:  F4
Expiration Date:
Footnote ID:  F2
Footnote ID:  F3
Footnote ID:  F4
Underlying Security:
Underlying Security Title:
Value:  Common Stock
Underlying Security Shares:
Value:  2,527
Post-Transaction Amounts:
Value Owned Following Transaction:
Value:  3,938,542.32
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  See Footnotes
Footnote ID:  F7
Footnote ID:  F9
Footnote ID:  F10
Derivative Transaction:
Security Title:
Value:  Convertible Debt (PIK Amount)
Footnote ID:  F1
Footnote ID:  F2
Footnote ID:  F3
Footnote ID:  F4
Footnote ID:  F5
Conversion or Exercise Price:
Value:  9.34
Footnote ID:  F2
Footnote ID:  F3
Footnote ID:  F4
Transaction Date:
Value:  9/1/22
Deemed Execution Date:
Transaction Coding:
Transaction Form Type:  4
Transaction Code:  J
Equity Swap Involved?  No
Footnote ID:  F2
Footnote ID:  F3
Footnote ID:  F4
Footnote ID:  F5
Transaction Timeliness:
Value:
Transaction Amounts:
Transaction Total Value:
Value:  23,598.41
Transaction Price Per Share:
Footnote ID:  F2
Footnote ID:  F3
Footnote ID:  F4
Transaction Acquired-Disposed Code:
Value:  A
Exercise Date:
Footnote ID:  F2
Footnote ID:  F3
Footnote ID:  F4
Expiration Date:
Footnote ID:  F2
Footnote ID:  F3
Footnote ID:  F4
Underlying Security:
Underlying Security Title:
Value:  Common Stock
Underlying Security Shares:
Value:  2,527
Post-Transaction Amounts:
Value Owned Following Transaction:
Value:  3,938,542.32
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  See Footnotes
Footnote ID:  F8
Footnote ID:  F9
Footnote ID:  F10
Footnotes:
Footnote - F1:  This statement is being filed by SVB Financial Group ("SVB Financial"), SVB Innovation Credit Fund VIII, L.P. ("Fund VIII"), SVB Innovation Credit Partners VIII, LLC ("Fund VIII GP" and, together with Fund VIII, the "Fund VIII Entities"), Innovation Credit Fund VIII-A, L.P. ("Fund VIII-A") and SVB Innovation Credit Partners VIII-A, LLC ("Fund VIII-A GP" and, together with Fund VIII-A, the "Fund VIII-A Entities"). SVB Financial, the Fund VIII Entities and the Fund VIII-A Entities are referred to herein, collectively, as the "Reporting Persons".
Footnote - F2:  On December 22, 2021 (the "Effective Date"), Achieve Life Sciences, Inc. (the "Issuer") entered into a 2021 Contingent Convertible Debt Agreement (the "Convertible Debt Agreement"), by and among the Issuer, Silicon Valley Bank ("SVB") and Fund VIII (together with their respective successors and assigns, collectively, the "Lenders"). Pursuant to the Convertible Debt Agreement, the Lenders advanced an aggregate amount of $15,000,000 to the Issuer (the "Convertible Debt" or "Associated Debt"). The Associated Debt is convertible, at the election of each person or entity entitled to exercise the right to elect a voluntary conversion with respect to an interest in the Associated Debt (each, a "Conversion Right Holder" and collectively, the "Conversion Right Holders"), into a number of Common Stock shares equal to (A) the amount of Associated Debt (including interest accrued and required to be paid in kind by being added to the principal balance thereof (such amounts, "PIK Amounts"))
Footnote - F3:  (Continued from footnote 2) such Conversion Right Holder elects to convert, divided by (B) $9.34 (the "Conversion Right"). As of the Effective Date, SVB (i) sold a participation interest in $3,750,000 of its interest in the Associated Debt (such portion of the Associated Debt, the "Participated Debt" and the remaining portion of the Associated Debt held by SVB, the "Remaining SVB Associated Debt"), and assigned the Conversion Right related to the Participated Debt (including PIK Amounts) to Fund VIII-A and (ii) assigned its Conversion Right with respect to the Remaining SVB Associated Debt (including PIK Amounts) to SVB Financial. The Conversion Right Holders may voluntarily convert all or any part of the Associated Debt (including PIK Amounts)
Footnote - F4:  (Continued from footnote 3) at any time, provided that if the closing price per share of Issuer's Common Stock is equal to or greater than $24.00 for thirty (30) consecutive trading days, then the Associated Debt (including PIK Amounts) will mandatorily convert to Common Stock on the following trading day. The Associated Debt (including PIK Amounts) will be convertible for so long as such indebtedness remains outstanding.
Footnote - F5:  On September 1, 2022, the PIK Amounts set forth on Table II were added to the outstanding principal balance of the Associated Debt (including previously accrued PIK Amounts). The conversion of Associated Debt (including PIK Amounts) into Common Stock is limited to an amount of Common Stock which would not result in (i) the maximum aggregate number of Common Stock issuable to all Conversion Right Holders exceeding 1,889,763 shares of Common Stock, as such number may be adjusted for stock splits, stock dividends, reorganizations, recapitalizations and the like occurring after the Effective Date or (ii) the maximum aggregate number of Common Stock of the Issuer owned or held by SVB Financial beneficially and/or of record exceeding 19.99% of the Issuer's then-total issued and outstanding shares of Common Stock.
Footnote - F6:  Reflects Associated Debt (other than Participated Debt) held directly by SVB (including PIK Amounts), with the related Conversion Right exercisable by SVB Financial.
Footnote - F7:  Reflects Associated Debt (including PIK Amounts) and the related Conversion Right held directly by Fund VIII. Fund VIII GP is the general partner of Fund VIII and may be deemed to beneficially own indirectly Associated Debt and the related Conversion Right held directly by Fund VIII.
Footnote - F8:  Reflects Participated Debt in which Fund VIII-A holds directly a participation interest (including PIK Amounts) and the related Conversion Right held directly by Fund VIII-A. Fund VIII-A GP is the general partner of Fund VIII-A and may be deemed to beneficially own indirectly an interest in Participated Debt (including PIK Amounts) and the related Conversion Right held directly by Fund VIII-A.
Footnote - F9:  SVB Financial may be deemed to beneficially own indirectly any Associated Debt (including PIK Amounts and interests in Participated Debt) and Conversion Rights held by the Fund VIII Entities and the Fund VIII-A Entities. SVB Financial is the manager of Fund VIII GP and Fund VIII-A GP and the investment adviser to Fund VIII and Fund VIII-A. SVB is a wholly-owned subsidiary of SVB Financial.
Footnote - F10:  Pursuant to Rule 16a-1(a)(4) of the Securities Exchange Act of 1934 (the "Exchange Act"), this filing shall not be deemed an admission that the Reporting Persons are, for purposes of Section 16 of the Exchange Act or otherwise, the beneficial owner of any equity securities reported herein.
Remarks:
Owner Signature:
Signature Name:  /s/ Karen Hon, Karen Hon, Chief Accounting Officer, SVB Financial Group
Signature Date:  9/1/22
Owner Signature:
Signature Name:  /s/ Andrew Olson, Andrew Olson, Chief Financial Officer of SVB Innovation Credit Partners VIII, LLC
Signature Date:  9/1/22
Owner Signature:
Signature Name:  /s/ Andrew Olson, Andrew Olson, Chief Financial Officer of SVB Innovation Credit Partners VIII, LLC, general partner of SVB Innovation Credit Fund VIII, L.P.
Signature Date:  9/1/22
Owner Signature:
Signature Name:  /s/ Andrew Olson, Andrew Olson, Chief Financial Officer of SVB Innovation Credit Partners VIII-A, LLC
Signature Date:  9/1/22
Owner Signature:
Signature Name:  /s/ Andrew Olson, Andrew Olson, Chief Financial Officer of SVB Innovation Credit Partners VIII-A, LLC, general partner of Innovation Credit Fund VIII-A, L.P.
Signature Date:  9/1/22


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