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SEC FORM 4 SEC Form 4
FORM 4 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
or Section 30(h) of the Investment Company Act of 1940 		 
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
INTERWEST PARTNERS X LP
(Last) (First) (Middle)
2710 SAND HILL ROAD, SUITE 200
(Street)
MENLO PARK CA 94025
(City) (State) (Zip)
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)
3. Date of Earliest Transaction (Month/Day/Year)
10/12/2016
4. If Amendment, Date of Original Filed (Month/Day/Year)
 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. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 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 10/12/2016 C 1,615,041 A (1) 1,615,041 D(2)
Common Stock 10/12/2016 C 464,494 A (3) 2,079,535 D(2)
Common Stock 10/12/2016 C 373,803 A (4) 2,453,338 D(2)
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 (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 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 (Month/Day/Year) 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: 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
Series C Preferred Stock (1) 10/12/2016 C 1,615,041 (1) (1) Common Stock 1,615,041 (1) 0 D(2)
Series D Preferred Stock (3) 10/12/2016 C 464,494 (3) (3) Common Stock 464,494 (3) 0 D(2)
Series E Preferred Stock (4) 10/12/2016 C 373,803 (4) (4) Common Stock 373,803 (4) 0 D(2)
1. Name and Address of Reporting Person*
INTERWEST PARTNERS X LP
(Last) (First) (Middle)
2710 SAND HILL ROAD, SUITE 200
(Street)
MENLO PARK CA 94025
(City) (State) (Zip)
1. Name and Address of Reporting Person*
InterWest Management Partners X, LLC
(Last) (First) (Middle)
2710 SAND HILL ROAD, SUITE 200
(Street)
MENLO PARK CA 94025
(City) (State) (Zip)
1. Name and Address of Reporting Person*
GIANOS PHILIP T
(Last) (First) (Middle)
2710 SAND HILL ROAD, SUITE 200
(Street)
MENLO PARK CA 94025
(City) (State) (Zip)
1. Name and Address of Reporting Person*
Holmes W Stephen
(Last) (First) (Middle)
2710 SAND HILL ROAD, SUITE 200
(Street)
MENLO PARK CA 94025
(City) (State) (Zip)
1. Name and Address of Reporting Person*
Kliman Gilbert H
(Last) (First) (Middle)
2710 SAND HILL ROAD, SUITE 200
(Street)
MENLO PARK CA 94025
(City) (State) (Zip)
1. Name and Address of Reporting Person*
ORONSKY ARNOLD L
(Last) (First) (Middle)
2710 SAND HILL ROAD, SUITE 200
(Street)
MENLO PARK CA 94025
(City) (State) (Zip)
1. Name and Address of Reporting Person*
Desai Keval
(Last) (First) (Middle)
2710 SAND HILL ROAD, SUITE 200
(Street)
MENLO PARK CA 94025
(City) (State) (Zip)
1. Name and Address of Reporting Person*
NASR KHALED
(Last) (First) (Middle)
2710 SAND HILL ROAD, SUITE 200
(Street)
MENLO PARK CA 94025
(City) (State) (Zip)
Explanation of Responses:
1. Each share of the issuer's Series C Preferred Stock automatically converted into 1 share of the issuer's Common Stock on October 12, 2016 in connection with the closing of the issuer's sale of its Common Stock in its firm commitment initial public offering (the "IPO") pursuant to a registration statement on Form S-1 (File No. 333-213551) under the Securities Act of 1933, as amended (the "Registration Statement"), and had no expiration date.
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. Philip T. Gianos, W. Stephen Holmes, Gilbert H. Kliman and Arnold L. Oronsky are the managing directors of IMP10, and Keval Desai and Khalad A. Nasr are venture members of IMP10. Each of the reporting persons disclaims beneficial ownership of the securities reported herein for purposes of Rule 16a-1(a) under the Securities Exchange Act of 1934, as amended (the "Exchange Act"), except to the extent of its or his pecuniary interest therein, if any. The reporting persons have designated a representative, currently Doug Fisher, a consultant of InterWest Venture Management Co., to serve on the issuer's board of directors. This report shall not be deemed an admission that any of the reporting persons is a beneficial owner of such securities for the purposes of Section 16 of the Exchange Act, or for any other purposes.
3. Each share of the issuer's Series D Preferred Stock automatically converted into 1 share of the issuer's Common Stock on October 12, 2016 in connection with the closing of the issuer's sale of its Common Stock in its IPO pursuant to the Registration Statement, and had no expiration date.
4. Each share of the issuer's Series E Preferred Stock automatically converted into 1 share of the issuer's Common Stock on October 12, 2016 in connection with the closing of the issuer's sale of its Common Stock in its IPO pursuant to the Registration Statement, and had no expiration date.
Remarks:
/s/ Karen A. Wilson, Attorney-in-Fact for InterWest Partners X, LP 10/12/2016
/s/ Karen A. Wilson, Attorney-in-Fact for InterWest Management Partners X, LLC 10/12/2016
/s/ Karen A. Wilson, Attorney-in-Fact for Philip T. Gianos 10/12/2016
/s/ Karen A. Wilson, Attorney-in-Fact for W. Stephen Holmes 10/12/2016
/s/ Karen A. Wilson, Attorney-in-Fact for Gilbert Kliman 10/12/2016
/s/ Karen A. Wilson, Attorney-in-Fact for Arnold L. Oronsky 10/12/2016
/s/ Karen A. Wilson, Attorney-in-Fact for Keval Desai 10/12/2016
/s/ Karen A. Wilson, Attorney-in-Fact for Khaled A. Nasr 10/12/2016
** 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 Number.
FORM 4 JOINT FILER INFORMATION

Name of
"Reporting Persons":	InterWest Partners X, L.P. ("IW10")
			InterWest Management Partners X, LLC ("IMP10")

			Philip T. Gianos
			W. Stephen Holmes
			Gilbert H. Kliman
			Arnold L. Oronsky
			Keval Desai
			Khaled Nasr

Address:		2710 Sand Hill Road, Suite 200
			Menlo Park, CA  94025

Designated Filer:	InterWest Partners X, L.P.

Issuer and Ticker Symbol: Obalon Therapeutics, Inc. ("OBLN")

Date of Event:		October 12, 2016

Each of the following is a Joint Filer with InterWest Partners X L.P. ("IW10")
and may be deemed to share indirect beneficial ownership in the securities set
forth on the attached Form 4:

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. Philip
T. Gianos, W. Stephen Holmes, 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 has filed 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
1934, or otherwise, any of the Reporting Persons are the beneficial owner of all
of the equity securities covered by this statement.


Each of the Reporting Persons listed above has designated InterWest Partners X,
L.P. as its designated filer of Forms 3, 4 and 5 in accordance with Section
16(a) of the Securities Exchange Act of 1934 and the rules thereunder.  Each
Reporting Person has appointed InterWest Management Partners X, LLC as its
attorney in fact for the purpose of making reports relating to transaction in
Obalon Therapeutics, Inc. Common Stock.

INTERWEST MANAGEMENT PARTNERS X, L.L.C.

By:	/s/ Karen A. Wilson
	Karen A. Wilson, Power of Attorney


INTERWEST PARTNERS X, LP

By:	/s/ Karen A. Wilson
	Karen A. Wilson, Power of Attorney


Philip T. Gianos, an individual

By:	/s/ Karen A. Wilson
	Karen A. Wilson, Power of Attorney



Keval Desai, an individual

By:	/s/ Karen A. Wilson
	Karen A. Wilson, Power of Attorney



Gilbert H. Kliman, an individual

By:	/s/ Karen A. Wilson
	Karen A. Wilson, Power of Attorney



Arnold L. Oronsky, an individual

By:	/s/ Karen A. Wilson
	Karen A. Wilson, Power of Attorney



W. Stephen Holmes, an individual

By:	/s/ Karen A. Wilson
	Karen A. Wilson, Power of Attorney


Khaled A. Nasr, an individual


By:	/s/ Karen A. Wilson
	Karen A. Wilson, Power of Attorney