0000904454-17-000015.txt : 20170109 0000904454-17-000015.hdr.sgml : 20170109 20170109125936 ACCESSION NUMBER: 0000904454-17-000015 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20170109 DATE AS OF CHANGE: 20170109 SUBJECT COMPANY: 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 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-89741 FILM NUMBER: 17516694 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 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: DOMAIN PARTERS VII L P CENTRAL INDEX KEY: 0001374150 IRS NUMBER: 000000000 FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: ONE PALMER SQUARE SUITE 515 CITY: PRINCETON STATE: NJ ZIP: 08542 BUSINESS PHONE: 609-683-5656 MAIL ADDRESS: STREET 1: ONE PALMER SQUARE SUITE 515 CITY: PRINCETON STATE: NJ ZIP: 08542 SC 13G 1 s13g_010717-obalon.htm SCHEDULE 13G FOR OBALON THERAPEUTICS, INC. BY DOMAIN PARTNERS VII, L.P.

SECURITIES AND EXCHANGE COMMISSION
Washington, D.C.  20549
_____________________

SCHEDULE 13G
(Rule 13d-102)

INFORMATION TO BE INCLUDED IN STATEMENTS FILED PURSUANT
TO RULES 13d-1(b),(c) AND (d) AND AMENDMENTS THERETO FILED
PURSUANT TO RULE 13d-2(b)
(Amendment No.  )1

Obalon Therapeutics, Inc.
(Name of Issuer)
 
Common Stock, $0.001 par value
(Title of Class of Securities)
 
67424L100
(CUSIP Number)
 
December 31, 2016
Date of Event Which Requires Filing of this Statement
 

 
Check the appropriate box to designate the rule pursuant to which this Schedule is Filed:

[   ] Rule 13d-1(b)
[   ] Rule 13d-1(c)
[X] Rule 13d-1(d)


_______________________

1The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures provided in a prior cover page.  The information required on the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act.

 
 
 
 
 
 
CUSIP No. 67424L100

 
1)
Name of Reporting Person
I.R.S. Identification No. of Above Person (Entities Only) (Voluntary)
 
Domain Partners VII, L.P.
2)
Check the Appropriate Box if a Member of a Group
 
 
(a)  [X]
(b)  [   ]
3)
SEC Use Only
 
 
  
4)
Citizenship or Place of Organization
 
Delaware
 
Number of
Shares Beneficially
Owned by Each
Reporting Person
With
 
5)
Sole Voting Power
4,005,819 shares of Common Stock *
6)
Shared Voting Power
-0-
7)
Sole Dispositive Power
4,005,819 shares of Common Stock *
8)
Shared Dispositive Power
-0-
9)
Aggregate Amount Beneficially Owned by Each Reporting Person
 
4,005,819 shares of Common Stock *
10)
Check if the Aggregate Amount in Row (9) Excludes Certain Shares
 
[   ]
11)
Percent of Class Represented by Amount in Row (9)
 
23.9% **
12)
Type of Reporting Person
 
PN

* As of December 31, 2016 and including 19,849 shares issuable upon exercise of warrants to purchase Common Stock.
** Based on 16,773,205 shares of Common Stock outstanding as of December 31, 2016, as provided to the Reporting Persons by the Issuer.
 
 
 
2
 
 
CUSIP No. 67424L100

 
1)
Name of Reporting Person
I.R.S. Identification No. of Above Person (Entities Only) (Voluntary)
 
DP VII Associates, L.P.
2)
Check the Appropriate Box if a Member of a Group
 
 
(a)  [X]
(b)  [   ]
3)
SEC Use Only
 
 
  
4)
Citizenship or Place of Organization
 
Delaware
 
Number of
Shares Beneficially
Owned by Each
Reporting Person
With
5)
Sole Voting Power
 
49,908 shares of Common Stock *
6)
Shared Voting Power
 
-0-
7)
Sole Dispositive Power
 
49,908 shares of Common Stock *
8)
Shared Dispositive Power
 
-0-
9)
Aggregate Amount Beneficially Owned by Each Reporting Person
 
49,908 shares of Common Stock *
10)
Check if the Aggregate Amount in Row (9) Excludes Certain Shares
 
[   ]
11)
Percent of Class Represented by Amount in Row (9)
 
0.3% **
12)
Type of Reporting Person
 
PN

* As of December 31, 2016 and including 338 shares issuable upon exercise of warrants to purchase Common Stock.
** Based on 16,773,205 shares of Common Stock outstanding as of December 31, 2016, as provided to the Reporting Persons by the Issuer.

 
 
 
3
 
CUSIP No. 67424L100
 
 
Schedule 13G

Item 1(a)
–
Name of Issuer:
     
   
Obalon Therapeutics, Inc.
     
Item 1(b)
–
Address of Issuer's Principal Executive Offices:
     
   
5421 Avenida Encinas, Suite F, Carlsbad, CA  92008
     
Item 2(a)
–
Name of Person Filing:
     
   
This statement is being filed by Domain Partners VII, L.P., a Delaware limited partnership ("Domain VII"), and DP VII Associates, L.P., a Delaware limited partnership ("DP VII A") (together, the "Reporting Persons").
     
Item 2(b)
–
Address of Principal Business Office:
     
   
One Palmer Square, Princeton, NJ  08542
     
Item 2(c)
–
Place of Organization:
     
   
Domain VII:  Delaware
   
DP VII A:  Delaware
     
Item 2(d)
–
Title of Class of Securities:
     
   
Common Stock, $0.001 par value
     
Item 2(e)
–
CUSIP Number:
     
   
67424L100
     
Item 3
–
Statements Filed Pursuant to Rules 13d-1(b) or 13d-2(b):
     
   
Not applicable.
 
 
 
4
 
CUSIP No. 67424L100
 

Item 4
–
Ownership.
     
(a) through (c):
     
The information set forth in Items 5 through 9 and 11 of the cover pages to this Schedule 13G is incorporated herein by reference.
     
Item 5
–
Ownership of Five Percent or Less of a Class:
     
   
Not applicable.
     
Item 6
–
Ownership of More than Five Percent on Behalf of Another Person:
     
   
Not applicable.
     
Item 7
–
Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Company:
     
   
Not applicable.
     
Item 8
–
Identification and Classification of Members of the Group:
     
   
See Exhibit 2.
     
Item 9
–
Notice of Dissolution of Group:
     
   
Not applicable.
     
Item 10
–
Certification:
     
   
Not applicable.
 
 
 
 
5
 
CUSIP No. 67424L100

 
Signature

After reasonable inquiry and to the best of their knowledge and belief, the undersigned hereby certify that the information set forth in this statement is true, complete and correct.

Dated:  January 9, 2017

 
DOMAIN PARTNERS VII, L.P.
 
  
 
By:
One Palmer Square Associates VII, L.L.C., General Partner
 
  
 
By:
/s/ Lisa A. Kraeutler
  
   
Attorney-in-Fact
 
 
  
 
DP VII ASSOCIATES, L.P.
 
  
 
By:
One Palmer Square Associates VII, L.L.C., General Partner
 
  
 
By:
/s/ Lisa A. Kraeutler
  
   
Attorney-in-Fact
 
 
  

 
 
 

 
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CUSIP No. 67424L100

 
Exhibit 1

Joint Filing Agreement
The undersigned hereby agree that the statement on Schedule 13G to which this Agreement is annexed as Exhibit 1, and any amendments thereto, is and will be filed on behalf of each of them in accordance with the provisions of Rule 13d-1(k) under the Securities Exchange Act of 1934, as amended.
Dated:  January 9, 2017

 
DOMAIN PARTNERS VII, L.P.
 
  
 
By:
One Palmer Square Associates VII, L.L.C., General Partner
 
  
 
By:
/s/ Lisa A. Kraeutler
  
   
Attorney-in-Fact
 
 
  
 
DP VII ASSOCIATES, L.P.
 
  
 
By:
One Palmer Square Associates VII, L.L.C., General Partner
 
  
 
By:
/s/ Lisa A. Kraeutler
  
   
Attorney-in-Fact
 
 
  

 
 
 
7
 
CUSIP No. 67424L100

 
Exhibit 2

Identification and Classification of Members of the Group

Domain Partners VII, L.P. and DP VII Associates, L.P. are filing this statement on Schedule 13G as a group.

Domain Partners VII, L.P. is a Delaware limited partnership.  Its sole general partner is One Palmer Square Associates VII, L.L.C., a Delaware limited liability company.

DP VII Associates, L.P. is a Delaware limited partnership.  Its sole general partner is One Palmer Square Associates VII, L.L.C., a Delaware limited liability company.

 
 
 
 

8