0001251769-22-000014.txt : 20220228 0001251769-22-000014.hdr.sgml : 20220228 20220228161444 ACCESSION NUMBER: 0001251769-22-000014 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220225 FILED AS OF DATE: 20220228 DATE AS OF CHANGE: 20220228 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gostout Christopher J. CENTRAL INDEX KEY: 0001694007 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35706 FILM NUMBER: 22689713 MAIL ADDRESS: STREET 1: C/O APOLLO ENDOSURGERY, INC., 1120 S. STREET 2: CAPITAL OF TEXAS HWY, BLDG. 1, SUITE 300 CITY: AUSTIN STATE: TX ZIP: 78746 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Apollo Endosurgery, Inc. CENTRAL INDEX KEY: 0001251769 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 161630142 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1120 SOUTH CAPITAL OF TX HWY STREET 2: BUILDING 1 SUITE 300 CITY: AUSTIN STATE: TX ZIP: 78746 BUSINESS PHONE: 512-279-5100 MAIL ADDRESS: STREET 1: 1120 SOUTH CAPITAL OF TX HWY STREET 2: BUILDING 1 SUITE 300 CITY: AUSTIN STATE: TX ZIP: 78746 FORMER COMPANY: FORMER CONFORMED NAME: LPATH, INC DATE OF NAME CHANGE: 20060316 FORMER COMPANY: FORMER CONFORMED NAME: LPATH INC DATE OF NAME CHANGE: 20051202 FORMER COMPANY: FORMER CONFORMED NAME: NEIGHBORHOOD CONNECTIONS INC DATE OF NAME CHANGE: 20040323 4 1 wf-form4_164608283388960.xml FORM 4 X0306 4 2022-02-25 0 0001251769 Apollo Endosurgery, Inc. APEN 0001694007 Gostout Christopher J. 1120 SOUTH CAPITAL OF TEXAS HIGHWAY BUILDING ONE, STE 300 AUSTIN TX 78746 0 1 0 0 Chief Medical Officer Common Stock 2022-02-25 4 A 0 12920 0 A 90267 D Stock Option (Right to Buy) 5.63 2022-02-25 4 A 0 6635 0 A 2032-02-25 Common Stock 6635.0 6635 D Represents the grant of Restricted Stock Units ("RSUs"). Each RSU provides the Reporting Person with a contingent right to receive one share of the Issuer's common stock pursuant to the Issuer's 2017 Equity Incentive Plan (the "Plan"). The RSUs vest in equal annual installments over four years commencing on the grant date, subject to the Reporting Person providing continuous service to the Issuer through each such date. Accelerated vesting may occur in the event of a Change in Control, as that term is defined in the Plan. The shares underlying the option shall vest as to 25% on the first anniversary of the grant date and the remainder will vest in equal monthly installments over the following three years, subject to the Reporting Person providing continuous service to the Issuer through each such date. Accelerated vesting may occur in the event of a Change in Control, as that term is defined in the Apollo Endosurgery, Inc. 2017 Equity Incentive Plan. The number of shares listed in this column does not include other outstanding equity awards granted with different exercise prices, vesting conditions and other terms. /s/ Brian Szymczak - Attorney-in-Fact 2022-02-28