0001214659-17-006341.txt : 20171102 0001214659-17-006341.hdr.sgml : 20171102 20171102142354 ACCESSION NUMBER: 0001214659-17-006341 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171031 FILED AS OF DATE: 20171102 DATE AS OF CHANGE: 20171102 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Brister Mark CENTRAL INDEX KEY: 0001323223 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37897 FILM NUMBER: 171171734 MAIL ADDRESS: STREET 1: C/O DEXCOM, INC. STREET 2: 5555 OBERLIN DRIVE CITY: SAN DIEGO STATE: CA ZIP: 92121 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-40047.xml PRIMARY DOCUMENT X0306 4 2017-10-31 0001427570 OBALON THERAPEUTICS INC OBLN 0001323223 Brister Mark C/O OBALON THERAPEUTICS, INC. 5421 AVENIDA ENCINAS, SUITE F CARLSBAD CA 92008 false true false false Chief Technology Officer Common Stock 2017-10-31 4 A false 1860 7.17 A 163870 D These shares were acquired under the Obalon Therapeutics, Inc. 2016 Employee Stock Purchase Plan in transactions that were exempt under both Rule 16b-3(d) and Rule 16b-3(c). /s/ Nooshin Hussainy as attorney-in-fact for Mark Brister 2017-11-02