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 OF SECURITIES
                                                                                  
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response...
0.5
                      
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
                      

1. Name and Address of Reporting Person *

DOMAIN PARTERS VII L P
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)

C/O DOMAIN ASSOCIATES, LLC, 202 CARNEGIE CENTER, SUITE 104
3. Date of Earliest Transaction (MM/DD/YYYY)

8/6/2019
(Street)

PRINCETON, NJ 08540
(City)        (State)        (Zip)
4. If Amendment, Date Original Filed (MM/DD/YYYY)

 
6. Individual or Joint/Group Filing (Check Applicable Line)

___ Form filed by One Reporting Person
_ X _ Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Trans. Date 2A. Deemed Execution Date, if any 3. Trans. 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   8/6/2019     P    250000   A $4.00   (1) 813433   (2) D   (3) (4)
 

Table II - Derivative Securities Beneficially Owned ( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivate Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Trans. Date 3A. Deemed Execution Date, if any 4. Trans. 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 7. Title and Amount of Securities Underlying Derivative Security
(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 to Purchase Common Stock   $4.40   8/6/2019     P      187500       8/6/2019   8/6/2024   Common Stock   187500   $4.00   (1) 187500   D   (3)
 

Explanation of Responses:
(1)  The reported securities were purchased as Units, each Unit consisting of one share of Common Stock and a Warrant to purchase 0.75 of one share of Common Stock, at a purchase price of $4.00 per Unit.
(2)  The reported ownership reflects the one-for-ten reverse split of the Common Stock effected on July 24, 2019.
(3)  The securities reported as directly beneficially owned by the designated Reporting Person may be deemed to be indirectly beneficially owned by each of the Reporting Owners listed below, each of whom is a managing member of One Palmer Square Associates VII, LLC, the sole general partner of the designated Reporting Person. Pursuant to Instruction 4(b)(iv) of Form 4, each such individual has elected to report as indirectly beneficially owned the entire number of securities owned by the designated Reporting Person, however each of them disclaims beneficial ownership of any securities, and any proceeds thereof, that exceed his or her pecuniary interest therein and/or that are not actually distributed to him or her.
(4)  As managing members of One Palmer Square Associates VII, LLC, which is also the sole general partner of DP VII Associates, L.P., each Reporting Owner listed below may also be deemed to indirectly beneficially own 4,957 shares of Common Stock held by DP VII Associates, L.P.

Reporting Owners
Reporting Owner Name / Address
Relationships
Director 10% Owner Officer Other
DOMAIN PARTERS VII L P
C/O DOMAIN ASSOCIATES, LLC
202 CARNEGIE CENTER, SUITE 104
PRINCETON, NJ 08540

X

BLAIR JAMES C
C/O DOMAIN ASSOCIATES, LLC
202 CARNEGIE CENTER, SUITE 104
PRINCETON, NJ 08540

X

DOVEY BRIAN H
C/O DOMAIN ASSOCIATES, LLC
202 CARNEGIE CENTER, SUITE 104
PRINCETON, NJ 08540

X

TREU JESSE I
C/O DOMAIN ASSOCIATES, LLC
202 CARNEGIE CENTER, SUITE 104
PRINCETON, NJ 08540

X

VITULLO NICOLE
C/O DOMAIN ASSOCIATES, LLC
202 CARNEGIE CENTER, SUITE 104
PRINCETON, NJ 08540

X

Halak Brian K
C/O DOMAIN ASSOCIATES, LLC
202 CARNEGIE CENTER, SUITE 104
PRINCETON, NJ 08540

X


Signatures
/s/ Lisa A. Kraeutler, as Attorney-in-Fact for Domain Partners VII, L.P., J. Blair, B. Dovey, J. Treu, N. Vitullo and B. Halak 8/8/2019
** Signature of Reporting Person Date


Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number.
Obalon Therapeutics (NASDAQ:OBLN)
Historical Stock Chart
From Apr 2020 to May 2020 Click Here for more Obalon Therapeutics Charts.
Obalon Therapeutics (NASDAQ:OBLN)
Historical Stock Chart
From May 2019 to May 2020 Click Here for more Obalon Therapeutics Charts.