0001214659-19-004751.txt : 20190725 0001214659-19-004751.hdr.sgml : 20190725 20190725163017 ACCESSION NUMBER: 0001214659-19-004751 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190723 FILED AS OF DATE: 20190725 DATE AS OF CHANGE: 20190725 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MacDonald Robert J CENTRAL INDEX KEY: 0001778547 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37897 FILM NUMBER: 19974770 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-45369.xml PRIMARY DOCUMENT X0306 4 2019-07-23 0001427570 OBALON THERAPEUTICS INC OBLN 0001778547 MacDonald Robert J C/O OBALON THERAPEUTICS, INC. 5421 AVENDA ENCINAS, SUITE F CARLSBAD CA 92008 false true false false Chief Retail Officer Stock Option (Right to Buy) .96 2019-07-23 4 A false 35000 0 A 2029-07-23 Common Stock 35000 35000 D Subject to the grantee's continued status as a service provider with the Issuer through the applicable vesting date, the option shall vest as to 100% of the shares underlying the option on the day following the filing date of the Company's Annual Report on Form 10-K for the fiscal year ended December 31, 2019, based on the achievement of performance goals on or prior to December 31, 2019. Share amounts do not reflect the impact of a 1-for-10 reverse stock split that became effective after the grant date for the options referenced herein. /s/ Nooshin Hussainy as attorney-in-fact for Robert J. MacDonald 2019-07-25