0001209191-16-149825.txt : 20161114
0001209191-16-149825.hdr.sgml : 20161111
20161114174221
ACCESSION NUMBER: 0001209191-16-149825
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20161109
FILED AS OF DATE: 20161114
DATE AS OF CHANGE: 20161114
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
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Plovanic William J.
CENTRAL INDEX KEY: 0001685640
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37897
FILM NUMBER: 161996574
MAIL ADDRESS:
STREET 1: C/O OBALON THERAPEUTICS, INC.
STREET 2: 5421 AVENIDA ENCINAS, SUITE F
CITY: CARLSBAD
STATE: CA
ZIP: 92008
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2016-11-09
0
0001427570
OBALON THERAPEUTICS INC
OBLN
0001685640
Plovanic William J.
C/O OBALON THERAPEUTICS, INC.
5421 AVENIDA ENCINAS, SUITE F
CARLSBAD
CA
92008
0
1
0
0
Chief Financial Officer
Stock Option (right to buy)
8.74
2016-11-09
4
A
0
55000
0.00
A
2026-11-09
Common Stock
55000
55000
D
The option vests as to 25% of the total shares on March 7, 2017, and then 2.0833% of the total shares monthly thereafter, with 100% of the total shares vested on March 7, 2020, subject to the reporting person's provision of service to the issuer on each vesting date.
/s/ Nooshin Hussainy as attorney-in-fact for William Plovanic
2016-11-14