0001214659-18-000188.txt : 20180104
0001214659-18-000188.hdr.sgml : 20180104
20180104161347
ACCESSION NUMBER: 0001214659-18-000188
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: Plovanic William J.
CENTRAL INDEX KEY: 0001685640
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37897
FILM NUMBER: 18510261
MAIL ADDRESS:
STREET 1: C/O OBALON THERAPEUTICS, INC.
STREET 2: 5421 AVENIDA ENCINAS, SUITE F
CITY: CARLSBAD
STATE: CA
ZIP: 92008
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-40646.xml
PRIMARY DOCUMENT
X0306
4
2018-01-02
0001427570
OBALON THERAPEUTICS INC
OBLN
0001685640
Plovanic William J.
C/O OBALON THERAPEUTICS, INC.
5421 AVENIDA ENCINAS, SUITE F
CARLSBAD
CA
92008
false
true
false
false
Chief Financial Officer
Stock Option (Right to Buy)
7.15
2018-01-02
4
A
false
100000
0.00
A
2028-01-02
Common Stock
100000
100000
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. In addition, any portion of the Option that vests will not be exercisable until Mr. Plovanic relocates his primary residence to within 35 miles of the Company's headquarters (at the time of the relocation), provided that such relocation must occur no later than the second anniversary of the Grant Date. The Option will automatically expire if Mr. Plovanic does not satisfy this requirement prior to or on the second anniversary of the Grant Date.
/s/ Nooshin Hussainy as attorney-in-fact for William J. Plovanic
2018-01-04