Sec Form 4 Filing - INTERWEST PARTNERS X LP @ OBALON THERAPEUTICS INC - 2019-08-06

Insider filing report for Changes in Beneficial Ownership
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FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
INTERWEST PARTNERS X LP
2. Issuer Name and Ticker or Trading Symbol
OBALON THERAPEUTICS INC [ OBLN]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director X __ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
2710 SAND HILL ROAD, SUITE 200
3. Date of Earliest Transaction (MM/DD/YY)
08/06/2019
(Street)
MENLO PARK, CA94025
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
_____ Form filed by One Reporting Person
__ X __ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 08/06/2019 P 25,000 ( 1 ) A $ 4 ( 1 ) 380,224 ( 2 ) D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4, and 5)
6. Date Exercisable and Expiration Date
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Warrants (Right to buy) $ 4.4 08/06/2019 P 18,750 ( 1 ) 08/06/2019 08/05/2024 COMMON 18,750 $ 0 ( 1 ) 18,750 ( 2 ) D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
INTERWEST PARTNERS X LP
2710 SAND HILL ROAD, SUITE 200
MENLO PARK, CA94025
X
InterWest Management Partners X, LLC
2710 SAND HILL ROAD, SUITE 200
MENLO PARK, CA94025
X
Kliman Gilbert H
2710 SAND HILL ROAD, SUITE 200
MENLO PARK, CA94025
X
ORONSKY ARNOLD L
2710 SAND HILL ROAD, SUITE 200
MENLO PARK, CA94025
X
Desai Keval
2710 SAND HILL ROAD, SUITE 200
MENLO PARK, CA94025
X
NASR KHALED
2710 SAND HILL ROAD, SUITE 200
MENLO PARK, CA94025
X
Signatures
/s/ Karen A. Wilson, Attorney-in-Fact for InterWest Partners X, LP 08/08/2019
Signature of Reporting Person Date
/s/ Karen A. Wilson, Attorney-in-Fact for InterWest Management Partners X, L.L.C. 08/08/2019
Signature of Reporting Person Date
/s/ Karen A. Wilson, Attorney-in-Fact for Gilbert Kliman 08/08/2019
Signature of Reporting Person Date
/s/ Karen A. Wilson, Attorney-in-Fact for Arnold L. Oronsky 08/08/2019
Signature of Reporting Person Date
/s/ Karen A. Wilson, Attorney-in-Fact for Keval Desai 08/08/2019
Signature of Reporting Person Date
/s/ Karen A. Wilson, Attorney-in-Fact for Khaled A. Nasr 08/08/2019
Signature of Reporting Person Date
Explanation of Responses:
( 1 )The reporting persons purchased these shares directly from the underwriter in the Issuer's registered offering of Common Stock with 75% warrant coverage at a price of $4.00 per unit. There was no additional consideration paid for the warrants.
( 2 )These securities are held of record by InterWest Partners X, L.P. ("IW10"). InterWest Management Partners X, LLC ("IMP10") is the general partner of IW10 and has sole voting and investment control over the shares owned by IW10. Gilbert H. Kliman, and Arnold L. Oronsky are Managing Directors of IMP10 and, Keval Desai and Khaled A. Nasr, and are Venture Members of IMP10. Douglas Fisher, a Member of IMP10 is also a Director of the Issuer, and when required, files a separate Form 4 in his own name. All Reporting Persons disclaim beneficial ownership of shares of Obalon Therapeutics, Inc. stock held by IW10, except to the extent of their respective pecuniary interest therein. The filing of this statement shall not be deemed an admission that, for purposes of Section 16 of the Securities Exchange Act of 1944, or otherwise, any of the Reporting Persons are the beneficial owner of all of the equity securities covered by this statement.

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