0001214659-17-001219.txt : 20170217 0001214659-17-001219.hdr.sgml : 20170217 20170217132106 ACCESSION NUMBER: 0001214659-17-001219 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20170201 FILED AS OF DATE: 20170217 DATE AS OF CHANGE: 20170217 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: Morisey Erin CENTRAL INDEX KEY: 0001698303 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37897 FILM NUMBER: 17620677 MAIL ADDRESS: STREET 1: 712 BANCROFT ROAD, #119 CITY: WALNUT CREEK STATE: CA ZIP: 94598 3 1 marketforms-37990.xml PRIMARY DOCUMENT X0206 3 2017-02-01 0 0001427570 OBALON THERAPEUTICS INC OBLN 0001698303 Morisey Erin C/O OBALON THERAPEUTICS, INC. 5421 AVENIDA ENCINAS, STUIE F CARLSBAD CA 92008 false true false false VP Strategic Partnerships Stock Option (right to buy) 2.82 2026-07-27 Common Stock 17586 D Stock Option (right to buy) 8.74 2026-11-09 Common Stock 5000 D This option vests as to 25% of the total shares on July 25, 2017, then 2.083% monthly, with 100% of the total shares vested on July 25, 2020, subject to the reporting person's provision of service to the Issuer on each vesting date. This option vests as to 25% of the total shares on July 25, 2017, then 1.5625% monthly, with 100% of the total shares vested on July 25, 2021, subject to the reporting person's provision of service to the Issuer on each vesting date. /s/ Nooshin Hussainy as attorney-in-fact for Erin Morisey 2017-02-17 EX-24 2 poa.htm POA DOCUMENT

      The undersigned hereby constitutes and appoints William Plovanic, Andrew Rasdal
and Nooshin Hussainy, as long as they are providing services to Obalon
Therapeutics, Inc., a Delaware corporation (the "Company"), or either of them,
the undersigned's true and lawful attorney-in-fact to:

(1) execute for and on behalf of the undersigned, in the undersigned's capacity
as an officer and/or director of the Company, Forms 3, 4s and 5s in accordance
with Section 16(a) of the Securities Exchange Act of 1934, as amended (the
"Exchange Act"), and the rules and regulations thereunder;

(2) do and perform any and all acts for and on behalf of the undersigned that
may be necessary or desirable to complete and execute any such Forms 3, 4s and
5s and timely file such forms with the Securities and Exchange Commission and
any stock exchange or similar authority, if required; and

(3) take any other action of any type whatsoever in connection with the
foregoing that, in the opinion of such attorney-in-fact, may be of benefit to,
in the best interest of, or legally required by, the undersigned, it being
understood that the documents executed by such attorney-in-fact on behalf of the
undersigned pursuant to this Power of Attorney shall be in such form and shall
contain such terms and conditions as such attorney-in-fact may approve in such
attorney-in-fact's discretion.

The undersigned hereby grants to each such attorney-in-fact full power and
authority to do and perform each and every act and thing whatsoever requisite,
necessary or proper to be done in the exercise of any of the rights and powers
herein granted, as fully to all intents and purposes as the undersigned might or
could do if personally present, with full power of substitution and revocation,
hereby ratifying and confirming all that each such attorney-in-fact, or each
such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to
be done by virtue of this power of attorney and the rights and powers herein
granted. The undersigned acknowledges that each of the foregoing
attorneys-in-fact, in serving in such capacity at the request of the
undersigned, is not assuming, nor is the Company assuming, any of the
undersigned's responsibilities to comply with Section 16 of the Exchange Act.

The undersigned agrees that each such attorney-in-fact may rely entirely on
information furnished orally or in writing by the undersigned to each such
attorney-in-fact. The undersigned also agrees to indemnify and hold harmless the
Company and each such attorney-in-fact against any losses, claims, damages or
liabilities (or actions in these respects) that arise out of or are based on any
untrue statement or omission of necessary facts in the information provided by
the undersigned to such attorney-in-fact for purposes of executing,
acknowledging, delivering and filing Forms 3, 4s or 5s (including amendments
thereto) and agrees to reimburse the Company and each such attorney-in-fact for
any legal or other expenses reasonably incurred in connection with investigating
or defending against any such loss, claim, damage, liability or action.

This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4s and 5s with respect to the
undersigned's holdings of and transactions in securities issued by the Company,
unless earlier revoked by the undersigned in a signed writing delivered to the
foregoing attorneys-in-fact.

IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of this 17th day of February, 2017.

/s/ Name: Erin Morissey