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