X0306 4 2017-11-15 0 0001251769 Apollo Endosurgery, Inc. APEN 0001445999 Anderson Rick D 3600 N CAPITAL OF TEXAS HWY, SUITE B180 AUSTIN TX 78746 1 0 1 0 Common Stock 2017-11-15 4 J 0 1266909 D 0 I By PTV Evergreen Fund, L.P. Common Stock 2017-11-15 4 J 0 12669 A 12669 I By PTV GP Evergreen, L.P. Common Stock 2017-11-15 4 J 0 12669 D 0 I By PTV GP Evergreen, L.P. Common Stock 2017-11-15 4 J 0 4223 A 49677 D Common Stock 2199186 I By PTV Sciences II, L.P. Common Stock 1347565 I By PTV IV, L.P. Common Stock 605712 I By PTV Special Opportunities I, L.P. Represents in-kind distribution by PTV Evergreen Fund, L.P. to its partners (including PTV GP Evergreen, L.P.) without consideration. These securities are owned by PTV Evergreen Fund, L.P. ("PTV EG"). PTV GP III Management, LLC ("PTV GPM") is the sole general partner of PTV GP Evergreen, L.P. ("PTV GP EG"), which is the sole general partner of PTV EG. The managers of PTV GPM are Matthew S. Crawford and Rick D. Anderson, who may be deemed to share voting and investment control over the shares owned by PTV EG. The Reporting Person disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein. These securities are owned by PTV GP EG. PTV GPM is the sole general partner of PTV GP EG. Accordingly, PTV GPM may be deemed to have voting and investment control over the shares owned by PTV GP EG. The managers of PTV GPM are Matthew S. Crawford and Rick D. Anderson, who may be deemed to share voting and investment control over the shares owned by PTV GP EG. The Reporting Person disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein. Represents in-kind distribution by PTV GP EG to its partners (including the Reporting Person) without consideration. These securities are owned by PTV Sciences II, L.P. ("PTV II"). Pinto TV GP Company LLC ("PTV GPC") is the sole general partner of Pinto Technology Ventures GP II, L.P. ("PTV GP II"), which is the sole general partner of PTV II. The managers of PTV GPC are Matthew S. Crawford and Rick D. Anderson, who may be deemed to share voting and investment control over the shares owned by PTV II. The Reporting Person disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein. These securities are owned by PTV IV, L.P. ("PTV IV"). PTV GP III Management, LLC ("PTV GPM") is the sole general partner of PTV GP IV, L.P. ("PTV GP IV"), which is the sole general partner of PTV IV. The managers of PTV GPM are Matthew S. Crawford and Rick D. Anderson, who may be deemed to share voting and investment control over the shares owned by PTV IV. The Reporting Person disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein. These securities are owned by PTV Special Opportunities I, L.P. ("PTV SO"). PTV GP III Management, LLC ("PTV GPM") is the sole general partner of PTV GP SO I, L.P. ("PTV GP SO"), which is the sole general partner of PTV SO. The managers of PTV GPM are Matthew S. Crawford and Rick D. Anderson, who may be deemed to share voting and investment control over the shares owned by PTV SO. The Reporting Person disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein. /s/ Rick D. Anderson 2017-11-30