0001214659-19-004756.txt : 20190725 0001214659-19-004756.hdr.sgml : 20190725 20190725163025 ACCESSION NUMBER: 0001214659-19-004756 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190723 FILED AS OF DATE: 20190725 DATE AS OF CHANGE: 20190725 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DITTAMORE RAYMOND V CENTRAL INDEX KEY: 0001203772 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37897 FILM NUMBER: 19974783 MAIL ADDRESS: STREET 1: P O BOX 2050 CITY: GLENWOOD SPRINGS STATE: CO ZIP: 81602 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: OBALON THERAPEUTICS INC CENTRAL INDEX KEY: 0001427570 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 5421 AVENIDA ENCINAS STREET 2: SUITE F CITY: San Diego STATE: CA ZIP: 92008 BUSINESS PHONE: 858-480-2400 MAIL ADDRESS: STREET 1: 5421 AVENIDA ENCINAS STREET 2: SUITE F CITY: San Diego STATE: CA ZIP: 92008 4 1 marketforms-45352.xml PRIMARY DOCUMENT X0306 4 2019-07-23 0001427570 OBALON THERAPEUTICS INC OBLN 0001203772 DITTAMORE RAYMOND V C/O OBALON THERAPEUTICS, INC. 5421 AVENIDA ENCINAS, SUITE F CARLSBAD CA 92008 true false false false Common Stock (Restricted Stock Units) 2019-07-23 4 A false 78125 0 A 105597 D This award will vest in full on the earlier of (i) the one-year anniversary of the grant date or (ii) the date of the annual meeting of the Issuer's stockholders immediately following the grant date. Share amounts do not reflect the impact of a 1-for-10 reverse stock split that became effective after the grant date for the options referenced herein. /s/ Nooshin Hussainy as attorney-in-fact for Ray Dittamore 2019-07-25