0001214659-19-000150.txt : 20190104 0001214659-19-000150.hdr.sgml : 20190104 20190104183043 ACCESSION NUMBER: 0001214659-19-000150 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190102 FILED AS OF DATE: 20190104 DATE AS OF CHANGE: 20190104 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: 19511619 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-43640.xml PRIMARY DOCUMENT X0306 4 2019-01-02 0001427570 OBALON THERAPEUTICS INC OBLN 0001685640 Plovanic William J. C/O OBALON THERAPEUTICS, INC. 5421 AVENIDA ENCINAS, SUITE F CARLSBAD CA 92008 false true false false Chief Financial Officer Stock Option (Right to Buy) 2.30 2019-01-02 4 A false 100000 0 A 2029-01-02 Common Stock 100000 100000 D The Option shall vest as to 1/48th of the Shares underlying the Option on each monthly anniversary of the Grant Date, subject to the grantee's continued status as a Service Provider with the Company through the applicable vesting date. /s/ Nooshin Hussainy as attorney-in-fact for William J. Plovanic 2019-01-04