0001214659-18-000192.txt : 20180104 0001214659-18-000192.hdr.sgml : 20180104 20180104161736 ACCESSION NUMBER: 0001214659-18-000192 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180102 FILED AS OF DATE: 20180104 DATE AS OF CHANGE: 20180104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Rasdal Andrew P CENTRAL INDEX KEY: 0001323238 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37897 FILM NUMBER: 18510321 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-40637.xml PRIMARY DOCUMENT X0306 4 2018-01-02 0001427570 OBALON THERAPEUTICS INC OBLN 0001323238 Rasdal Andrew P C/O OBALON THERAPEUTICS, INC. 5421 AVENIDA ENCINAS, SUITE F CARLSBAD CA 92008 true true false false President & CEO Stock Option (Right to Buy) 7.15 2018-01-02 4 A false 300000 0.00 A 2028-01-02 Common Stock 300000 300000 D The Option shall vest as to 1/48th of the Shares underlying the Option on each monthly anniversary of the Grant Date, subject to the grantee's continued status as a Service Provider with the Company through the applicable vesting date. /s/ Nooshin Hussainy as attorney-in-fact for Andrew Rasdal 2018-01-04