0001251769-22-000085.txt : 20221104 0001251769-22-000085.hdr.sgml : 20221104 20221104182221 ACCESSION NUMBER: 0001251769-22-000085 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20221104 FILED AS OF DATE: 20221104 DATE AS OF CHANGE: 20221104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Black Jeffrey G. CENTRAL INDEX KEY: 0001449439 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35706 FILM NUMBER: 221363373 MAIL ADDRESS: STREET 1: 4955 DIRECTORS PLACE CITY: SAN DIEGO STATE: CA ZIP: 92121 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_166760052642987.xml FORM 4 X0306 4 2022-11-04 0 0001251769 Apollo Endosurgery, Inc. APEN 0001449439 Black Jeffrey G. 1120 S. CAPITAL OF TEXAS HIGHWAY BUILDING ONE, SUITE 300 AUSTIN TX 78746 0 1 0 0 Chief Financial Officer Common Stock 2022-11-04 4 F 0 15060 6.46 D 332650 D This transaction is not a sale of shares by the Reporting Person in the open market. Instead, this represents shares that have been withheld by the Issuer to satisfy the Reporting Person's income tax and withholding obligation in connection with the vesting of the first tranche of previously reported performance-based vesting restricted stock units reported on the Form 4 dated August 11, 2021. This net settlement was approved by the Issuer's compensation committee. /s/ Brian Szymczak - Attorney-in-Fact 2022-11-04