0001570562-23-000072.txt : 20230509
0001570562-23-000072.hdr.sgml : 20230509
20230509182118
ACCESSION NUMBER: 0001570562-23-000072
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230508
FILED AS OF DATE: 20230509
DATE AS OF CHANGE: 20230509
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: 23903714
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
wf-form4_168367086260672.xml
FORM 4
X0407
4
2023-05-08
0
0001570562
Evolus, Inc.
EOLS
0001700836
MOATAZEDI DAVID
520 NEWPORT CENTER DR.
SUITE 1200
NEWPORT BEACH
CA
92660
1
1
0
0
See Remarks
0
Restricted Stock Units
2023-05-08
4
A
0
560000
0
A
Common Stock
560000.0
560000
D
Each performance-based restricted stock unit represents a contingent right to receive one share of the EOLS common stock.
40% of the stock units are eligible to vest if the average EOLS common stock closing price over 20 consecutive trading days is $30 or more and an additional 60% of the stock units are eligible to vest if the average EOLS common stock closing price over 20 consecutive trading days is $50 or more, in each case not later than five years after the grant of the award. Any units eligible to vest based on stock price will vest, subject to continued service, over the four-year period after the grant date.
President and Chief Executive Officer
/s/ Jeffrey J. Plumer, as attorney-in-fact for David Moatazedi
2023-05-09