0001570562-23-000098.txt : 20230816 0001570562-23-000098.hdr.sgml : 20230816 20230816202505 ACCESSION NUMBER: 0001570562-23-000098 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230814 FILED AS OF DATE: 20230816 DATE AS OF CHANGE: 20230816 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MOATAZEDI DAVID CENTRAL INDEX KEY: 0001700836 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38381 FILM NUMBER: 231179615 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: Evolus, Inc. CENTRAL INDEX KEY: 0001570562 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 461385614 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 520 NEWPORT CENTER DRIVE STREET 2: SUITE 1200 CITY: NEWPORT BEACH STATE: CA ZIP: 92660 BUSINESS PHONE: (949) 284-4555 MAIL ADDRESS: STREET 1: 520 NEWPORT CENTER DRIVE STREET 2: SUITE 1200 CITY: NEWPORT BEACH STATE: CA ZIP: 92660 4 1 wk-form4_1692231895.xml FORM 4 X0508 4 2023-08-14 0 0001570562 Evolus, Inc. EOLS 0001700836 MOATAZEDI DAVID 520 NEWPORT CENTER DR. SUITE 1200 NEWPORT BEACH CA 92660 1 1 0 0 See Remarks 1 Common Stock 2023-08-14 4 A 0 91803 0 A 701370 D Common Stock 2023-08-16 4 S 0 14778 10.27 D 686592 D Represents shares issuable on settlement of performance restricted stock units ("PSUs") granted to the reporting person in January 2023. On August 14, 2023, the Issuer's Compensation Committee certified that the reporting person had achieved the set corporate development goal as of May 9, 2023. One-third of the PSU (30,601 shares) was vested and delivered immediately upon certification of the goal achievement. The remaining two-thirds will vest annually on the anniversary of May 9, 2023 provided the reporting person remains in continuous service on each vesting date, subject to accelerated vesting in certain events, including certain terminations of the reporting person or upon certain changes of control of the issuer. The sales reported on this Form 4 were effected pursuant to a Rule 10b5-1 trading plan adopted by the Reporting Person and represent shares required to be sold by the Reporting Person to cover tax withholding obligations in connection with the vesting of the PSUs. President and Chief Executive Officer /s/ Jeffrey J. Plumer, as attorney-in-fact for David Moatazedi 2023-08-16