0001214659-20-000643.txt : 20200128 0001214659-20-000643.hdr.sgml : 20200128 20200128163028 ACCESSION NUMBER: 0001214659-20-000643 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200124 FILED AS OF DATE: 20200128 DATE AS OF CHANGE: 20200128 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: 20554720 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-47578.xml PRIMARY DOCUMENT X0306 4 2020-01-24 0001427570 OBALON THERAPEUTICS INC OBLN 0001685640 Plovanic William J. C/O OBALON THERAPEUTICS, INC. 5421 AVENIDA ENCINAS, SUITE F CARLSBAD CA 92008 true true false false President & CEO Restricted Stock Units 2020-01-24 4 A false 441125 0 A Common Stock 441125 441125 D Each restricted stock unit represents a right to receive one share of the Issuer's common stock, the cash equivalent thereof, or a combination of both, based on the achievement of stock price goals over a three-year performance period ending December 31, 2022. /s/ Nooshin Hussainy as attorney-in-fact for William J. Plovanic 2020-01-28