0001251769-21-000081.txt : 20210621 0001251769-21-000081.hdr.sgml : 20210621 20210621105147 ACCESSION NUMBER: 0001251769-21-000081 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210617 FILED AS OF DATE: 20210621 DATE AS OF CHANGE: 20210621 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Pacitti David CENTRAL INDEX KEY: 0001722733 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35706 FILM NUMBER: 211028433 MAIL ADDRESS: STREET 1: C/O APOLLO ENDOSURGERY, INC., 1120 S. STREET 2: CAPITAL OF TEXAS HWY, BLDG. 1, SUITE 300 CITY: AUSTIN STATE: TX ZIP: 78746 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Apollo Endosurgery, Inc. CENTRAL INDEX KEY: 0001251769 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 161630142 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1120 SOUTH CAPITAL OF TX HWY STREET 2: BUILDING 1 SUITE 300 CITY: AUSTIN STATE: TX ZIP: 78746 BUSINESS PHONE: 512-279-5100 MAIL ADDRESS: STREET 1: 1120 SOUTH CAPITAL OF TX HWY STREET 2: BUILDING 1 SUITE 300 CITY: AUSTIN STATE: TX ZIP: 78746 FORMER COMPANY: FORMER CONFORMED NAME: LPATH, INC DATE OF NAME CHANGE: 20060316 FORMER COMPANY: FORMER CONFORMED NAME: LPATH INC DATE OF NAME CHANGE: 20051202 FORMER COMPANY: FORMER CONFORMED NAME: NEIGHBORHOOD CONNECTIONS INC DATE OF NAME CHANGE: 20040323 4 1 wf-form4_162428709483516.xml FORM 4 X0306 4 2021-06-17 0 0001251769 Apollo Endosurgery, Inc. APEN 0001722733 Pacitti David C/O APOLLO ENDOSURGERY, INC. 1120 S. CAP OF TX HWY, BLDG. 1, STE 300 AUSTIN TX 78746 1 0 0 0 Common Stock 2021-06-17 4 A 0 3888 0 A 3888 D Non-Qualified Stock Option (right to buy) 8.86 2021-06-17 4 A 0 5271 8.86 A 2022-06-17 2031-06-17 Common Stock 5271.0 64710 D Fully vested at one year anniversary of grant date. /s/ Brian Szymczak - Attorney-in-Fact 2021-06-21