Form of CEO Retention Agreement



 Exhibit 10.13 

RETENTION AGREEMENT 

This Retention Agreement (the “Agreement”) is entered into by and between [Name] (the “Executive”) and
Obalon Therapeutics, Inc., a Delaware corporation (the “Company”), on                      , 2016, and is effective on the first
date on which a registration statement covering the initial public offering of the common stock of the Company is declared effective by the United States Securities and Exchange Commission (the “Effective Date”). 

1. Term of Agreement. 
 Except to the
extent renewed as set forth in this Section 1, this Agreement shall terminate the earlier of the third (3rd) anniversary of the Effective Date (the “Expiration Date”) or the date
the Executive’s employment with the Company terminates for a reason other than a Qualifying Termination or CIC Qualifying Termination; provided however, if a definitive agreement relating to a Change in Control has been signed by the
Company on or before Expiration Date, then this Agreement shall remain in effect through the earlier of: 
 (a) The date the
Executive’s employment with the Company terminates for a reason other than a Qualifying Termination or CIC Qualifying Termination, or 

(b) The date the Company has met all of its obligations under this Agreement following a termination of the Executive’s employment with
the Company due to a Qualifying Termination or CIC Qualifying Termination. 
 This Agreement shall renew automatically and continue in
effect for three (3) year periods measured from the initial Expiration Date, unless the Company provides Executive notice of non-renewal at least three (3) months prior to the date on which this Agreement would otherwise renew. 

2. Qualifying Termination. If the Executive is subject to a Qualifying Termination, then, subject to Sections 4, 9, and 10 below, Executive will be
entitled to the following benefits: 
 (a) Severance Benefits. The Company shall pay the Executive twelve (12) months of his or her
monthly base salary (at the rate in effect immediately prior to the actions that resulted in the Qualifying Termination). The Executive will receive his or her severance payment in a cash lump-sum in accordance with the Company’s standard
payroll procedures which will be made on the first business day occurring after the sixtieth (60th) day following the Separation, provided that the Release Conditions have been
satisfied.
 (b) Equity. Each of Executive’s then-outstanding and unvested Equity Awards (as defined below), including awards
that would otherwise vest only upon satisfaction of performance criteria (measured at 100% of target), shall accelerate and become vested and exercisable as to 100% of the then unvested shares subject to the Equity Award effective immediately prior
to the Separation. 
 (c) Continued Employee Benefits. If Executive timely elects continued coverage under the Consolidated
Omnibus Budget Reconciliation Act (“COBRA”), the Company shall pay the full amount of Executive’s COBRA premiums on behalf of the Executive for the Executive’s continued coverage under the Company’s health, dental and
vision plans, including coverage for the Executive’s eligible dependents, for the twelve (12) month period following the Executive’s Separation or, if earlier, until Executive is eligible to be covered under another substantially
equivalent medical insurance plan by a subsequent employer. Notwithstanding the foregoing, if the Company, in its sole discretion, determines that it cannot provide the foregoing subsidy of COBRA coverage without potentially violating or causing the
Company to incur additional expense as a result of noncompliance with applicable law (including, without limitation, Section 2716 of the Public Health Service Act), the Company instead shall provide to Executive a taxable monthly payment in an
amount equal to the monthly COBRA premium that Executive would be required to pay to continue the group health coverage in effect on the date of the Separation (which amount shall be based on the premium for the first month of COBRA coverage), which
payments 







 
shall be made regardless of whether Executive elects COBRA continuation coverage and shall commence on the later of (i) the first day of the month following the month in which Executive
experiences a Separation and (ii) the effective date of the Company’s determination of violation of applicable law, and shall end on the earlier of (x) the effective date on which Executive becomes covered by a health, dental or vision
insurance plan of a subsequent employer, and (y) the last day of the period twelve (12) months after the Separation, provided that, any taxable payments under Section 2(b) will not be paid before the first business day occurring after the
sixtieth (60th) day following the Separation and, once they commence, will include any unpaid amounts accrued from the date of Executive’s Separation (to the extent not otherwise satisfied
with continuation coverage). However, if the period comprising the sum of the sixty (60)-day period described in the preceding sentence and the ten (10)-day period described in Section 7(e)(3) below spans two calendar years, then the payments
which constitute deferred compensation subject to Section 409A will not in any case be paid in the first calendar year. Executive shall have no right to an additional gross-up payment to account for the fact that such COBRA premium amounts are
paid on an after-tax basis. 
 3. CIC Qualifying Termination. If the Executive is subject to a CIC Qualifying Termination, then, subject to Sections
4, 9, and 10 below, Executive will be entitled to the following benefits: 
 (a) Severance and Bonus Payments. The Company or its
successor shall pay the Executive (i) twelve (12) months of his or her monthly base salary (at the rate in effect immediately prior to the actions that resulted in the Separation) and (ii) a pro rata portion (based on number of months worked in the
Company’s fiscal year of the Separation) of Executive’s then-current target bonus opportunity. Such payment shall be paid in a cash lump sum payment in accordance with the Company’s standard payroll procedures, which payment will be
made on the first business day occurring after the sixtieth (60th) day following the Separation, provided that the Release Conditions have been satisfied. 

(b) Equity.  
  

	 	(i)	Post-IPO Equity Awards. Each of Executive’s then-outstanding Post-IPO Equity Awards, including awards that would otherwise vest only upon satisfaction of performance criteria, shall accelerate and become
vested and exercisable as to 100% of the then unvested shares subject to the Equity Award. “Post-IPO Equity Awards” means all options to purchase shares of Company common stock that are granted on or after the Effective Date, as
well as any and all other stock-based awards granted to the Executive, including but not limited to stock bonus awards, restricted stock, restricted stock units or stock appreciation rights that are granted on or after the Effective Date. Subject to
Section 4, the accelerated vesting described above shall be effective as of the Separation. 

  

	 	(ii)	Pre-IPO Equity Awards. For clarity, except as explicitly provided in Section 3(b)(iii) below, any options to purchase shares of Company common stock that were granted prior to the Effective Date, regardless of
whether or not exercised prior to the Effective Date (“Pre-IPO Equity Awards”), shall not be affected by or subject to this Agreement, and such Pre-IPO Equity Awards shall continue to be governed by the vesting and acceleration
provisions contained in the grant agreements for the Pre-IPO Equity Awards and, if applicable, any separate letter agreement pertaining to vesting acceleration of Pre-IPO Equity Awards entered into between the Company and Executive (such agreements,
collectively, the “Pre-IPO Equity Award Agreements”). 

  

	 	(iii)	 Non-Assumption of Equity Awards. Notwithstanding anything to the contrary, if the successor or acquiring
corporation (if any) of the Company refuses to assume, convert, replace or substitute Executive’s unvested Equity Awards, as provided in Section 2.1.1 of the Plan, in connection with a Corporate Transaction (as defined in the Plan), then
notwithstanding any other provision in this Agreement, the Plan or any Pre-IPO Equity Award Agreement to the contrary, 



  
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each of Executive’s then-outstanding and unvested Equity Awards that are not assumed, converted, replaced or substituted, including awards that would otherwise vest only upon satisfaction of
performance criteria (measured at 100% of target), shall accelerate and become vested and exercisable as to 100% of the then unvested shares subject to the Equity Award effective immediately prior to the Corporate Transaction. 


 

	 	(iv)	Death or Disability. Notwithstanding anything to the contrary herein, in the event Executive has a Separation due to Executive’s death or Disability and such Separation occurs (i) within twelve (12)
months following a Change in Control or (ii) within three (3) months preceding a Change in Control (but as to part (ii), only if the Separation occurs after a Potential Change in Control), each of Executive’s then-outstanding and unvested
Equity Awards, including awards that would otherwise vest only upon satisfaction of performance criteria (measured at 100% of target), shall accelerate and become vested and exercisable as to 100% of the then unvested shares subject to the Equity
Award effective immediately prior to the Separation.

 (c) Pay in Lieu of Continued Employee Benefits. If Executive
timely elects continued coverage under the Consolidated Omnibus Budget Reconciliation Act (“COBRA”), the Company or its successor shall pay the full amount of Executive’s COBRA premiums on behalf of the Executive for the
Executive’s continued coverage under the Company’s health, dental and vision plans, including coverage for the Executive’s eligible dependents, for the twelve (12) month period following the Executive’s Separation or, if earlier,
until Executive is eligible to be covered under another substantially equivalent medical insurance plan by a subsequent employer. Notwithstanding the foregoing, if the Company, in its sole discretion, determines that it cannot provide the
foregoing subsidy of COBRA coverage without potentially violating or causing the Company to incur additional expense as a result of noncompliance with applicable law (including, without limitation, Section 2716 of the Public Health Service Act), the
Company instead shall provide to Executive a taxable monthly payment in an amount equal to the monthly COBRA premium that Executive would be required to pay to continue the group health coverage in effect on the date of the Separation (which amount
shall be based on the premium for the first month of COBRA coverage), which payments shall be made regardless of whether Executive elects COBRA continuation coverage, shall commence on the later of (i) the first day of the month following the month
in which Executive experiences a Separation and (ii) the effective date of the Company’s determination of violation of applicable law, and shall end on the earlier of (x) the effective date on which Executive becomes covered by a health, dental
or vision insurance plan of a subsequent employer, and (y) the last day of the period twelve (12) months after the Separation, provided that, any taxable payments under Section 3(c) will not be paid before the first business day occurring
after the sixtieth (60th) day following the Separation and, once they commence, will include any unpaid amounts accrued from the date of Executive’s Separation (to the extent not otherwise
satisfied with continuation coverage). However, if the period comprising the sum of the sixty (60)-day period described in the preceding sentence and the ten (10)-day period described in Section 7(e)(3) below spans two calendar years, then the
payments which constitute deferred compensation subject to Section 409A will not in any case be paid in the first calendar year. Executive shall have no right to an additional gross-up payment to account for the fact that such COBRA premium
amounts are paid on an after-tax basis. 
 4. General Release. Any other provision of this Agreement notwithstanding, the benefits under
Section 2 and 3 shall not apply unless the Executive (i) has executed a general release (in substantially the form attached hereto as Exhibit A) of all known and unknown claims that he or she may then have against the Company or persons
affiliated with the Company and such release has become effective and (ii) has agreed not to prosecute any legal action or other proceeding based upon any of such claims. The release must be in the form prescribed by the Company, without
alterations (this document effecting the foregoing, the “Release”). The Company will deliver the form of Release to the Executive within thirty (30) days after the Executive’s Separation. The Executive must execute
and return the Release within the time period specified in the form. 

  
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 5. Accrued Compensation and Benefits. Notwithstanding anything to the contrary in Section 2
and 3 above, in connection with any termination of employment (whether or not a Qualifying Termination or CIC Qualifying Termination), the Company shall pay Executive’s earned but unpaid base salary and other vested but unpaid cash entitlements
for the period through and including the termination of employment, including unused earned vacation pay and unreimbursed documented business expenses incurred by Executive through and including the date of termination (collectively “Accrued
Compensation and Expenses”), as required by law and the applicable Company plan or policy. In addition, Executive shall be entitled to any other vested benefits earned by Executive for the period through and including the termination date
of Executive’s employment under any other employee benefit plans and arrangements maintained by the Company, in accordance with the terms of such plans and arrangements, except as modified herein (collectively “Accrued
Benefits”). Any Accrued Compensation and Expenses to which the Executive is entitled shall be paid to the Executive in cash as soon as administratively practicable after the termination and, in any event, no later than two and one-half
(2-1/2) months after the end of the taxable year of the Executive in which the termination occurs or at such earlier time as may be required by Section 10 below or to such lesser extent as may be mandated by Section 9 below. Any Accrued
Benefits to which the Executive is entitled shall be paid to the Executive as provided in the relevant plans and arrangements. 
 6. Covenants. 

(a) Non-Competition. The Executive agrees that, during his or her employment with the Company, he or she shall not engage in any
other employment, consulting or other business activity (whether full-time or part-time) that would create a conflict of interest with the Company. 

(b) Cooperation and Non-Disparagement. The Executive agrees that, during the six (6) month period following his or her cessation
of employment, he or she shall cooperate with the Company in every reasonable respect and shall use his or her best efforts to assist the Company with the transition of Executive’s duties to his or her successor. The Executive further
agrees that, during this six-month period, he or she shall not in any way or by any means disparage the Company, the members of the Company’s Board of Directors or the Company’s officers and employees. The Company agrees that, during
this six-month period, none of the members of its Board of Directors or its executive officers will disparage Executive. 
 7. Definitions. 

(a) “Cause” means: (i) Executive’s conviction for, or guilty plea to, a felony involving moral turpitude; (ii) a willful
refusal by Executive to comply with the lawful and reasonable instructions of the Company, or to otherwise perform Executive’s duties as lawfully and reasonably determined by the Company, in each case that is not cured by Executive (if such
refusal is of a type that is capable of being cured) within 15 days of written notice being given to Executive of such refusal; (iii) any willful act or acts of dishonesty undertaken by Executive and intended to result in Executive’s (or any
other person’s) material gain or personal enrichment at the expense of the Company or any of its customers, partners, affiliates, or employees; or (iv) any willful act of gross misconduct by Executive which is injurious to the Company. 

(b) “Code” means the Internal Revenue Code of 1986, as amended. 

(c) “Change in Control” For all purposes under this Agreement, a Change in Control shall mean a “Corporate
Transaction,” as such term is defined in the Plan, provided that the transaction (including any series of transactions) also qualifies as a change in control event under U.S. Treasury Regulation 1.409A-3(i)(5). 

(d) “CIC Qualifying Termination” means a Separation (i) within twelve (12) months following a Change in Control or (ii)
within three (3) months preceding a Change in Control (but as to part (ii), only if the Separation occurs after a Potential Change in Control) resulting, in either case (i) or (ii), from (A) the Company or its successor terminating the
Executive’s employment for any reason other than 

  
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Cause or (B) the Executive voluntarily resigning his or her employment for Good Reason. A termination or resignation due to the Executive’s death or disability shall not constitute a
CIC Qualifying Termination; provided, however, that, solely for purposes of Section 3(b)(iv) hereof, Executive’s Separation due to Executive’s death or Disability shall constitute a CIC Qualifying Termination. A “Potential
Change in Control” means the date of execution of a legally binding and definitive agreement for a corporate transaction which, if consummated, would constitute the applicable Change in Control (which for the avoidance of doubt, would
include a merger agreement, but not a term sheet for a merger agreement). In the case of a termination following a Potential Change in Control and before a Change in Control, solely for purposes of benefits under this Agreement, the date of
Separation will be deemed the date the Change in Control is consummated. 
 (e) “Disability” means the total and permanent
disability of Executive as defined by, or determined under, the Company’s (or, if applicable, the Company’s successor or acquiring corporation’s (if any)) long-term disability benefit plan as in effect at the time of Separation. 

(f) “Good Reason” means, without the Executive’s consent, (i) a reduction in Executive’s then-current base salary
(except for a reduction that is part of a proportional reduction of the base salaries of all Company executives), bonus opportunity or commissions opportunity; (ii) the offices of the Company that Executive is required to report to being moved such
that Executive’s usual commuting distance is increased by more than ten (10) miles; (iii) a material and adverse change to Executive’s duties or responsibilities (iv) a change to Executive’s title and/or role, after
which Executive is not both the Chief Executive Officer of the top-level acquiring entity whose stock is publicly traded and a voting member of its Board of Directors; (v) Executive is not, so long as Executive is Chief Executive Officer of the
Company, a voting member of the Company’s Board of Directors; or (vi) the Company provides notice that this Agreement will not be renewed, as set forth in Section 1 hereof; provided, however, that a resignation by Executive shall not be
considered to be for a “Good Reason” unless (i) Executive provides written notice to the Company’s Board of Directors of the occurrence of the event which Executive contends constitutes Good Reason within ninety (90) days of the date
such event occurs, which notice states Executive’s intention to resign for a “Good Reason” under this Agreement as a result thereof, (ii) the Company does not effect a cure with respect to such event within thirty (30) days of
receipt of such written notice, and (iii) Executive thereafter resigns and ceases to perform services as an employee of the Company within ten (10) days of the expiration of the Company’s cure period. 

(g) “Plan” means the Company’s 2016 Equity Incentive Plan, as may be amended from time to time. 

(h) “Release Conditions” mean the following conditions: (i) Company has received the Executive’s executed Release in the
form attached hereto as Exhibit A and (ii) any rescission period applicable to the Executive’s executed Release has expired.
 (i)
“Qualifying Termination” means a Separation that is not a CIC Qualifying Termination, but which results from (i) the Company terminating the Executive’s employment for any reason other than Cause or (ii) the Executive
voluntarily resigning his or her employment for Good Reason. A termination or resignation due to the Executive’s death or disability shall not constitute a Qualifying Termination.

(j) “Separation” means a “separation from service,” as defined in the regulations under Section 409A of the Code.

 8. Successors. 
 (a)
Company’s Successors. The Company shall require any successor (whether direct or indirect and whether by purchase, lease, merger, consolidation, liquidation or otherwise) to all or substantially all of the Company’s business
and/or assets, by an agreement in substance and form 

  
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satisfactory to the Executive, to assume this Agreement and to agree expressly to perform this Agreement in the same manner and to the same extent as the Company would be required to perform it
in the absence of a succession. For all purposes under this Agreement, the term “Company” shall include any successor to the Company’s business and/or assets or which becomes bound by this Agreement by operation of law. 

(b) Executive’s Successors. This Agreement and all rights of the Executive hereunder shall inure to the benefit of, and be
enforceable by, the Executive’s personal or legal representatives, executors, administrators, successors, heirs, distributees, devisees and legatees. 

9. Golden Parachute Taxes. 
 (a) Best
After-Tax Result. In the event that any payment or benefit received or to be received by Executive pursuant to this Agreement or otherwise (“Payments”) would (i) constitute a “parachute payment” within the
meaning of Section 280G of the Code and (ii) but for this subsection (a), be subject to the excise tax imposed by Section 4999 of the Code, any successor provisions, or any comparable federal, state, local or foreign excise tax (“Excise
Tax”), then, subject to the provisions of Section 10, such Payments shall be either (A) provided in full pursuant to the terms of this Agreement or any other applicable agreement, or (B) provided as to such lesser extent which would result
in no portion of such Payments being subject to the Excise Tax (“Reduced Amount”), whichever of the foregoing amounts, taking into account the applicable federal, state, local and foreign income, employment and other taxes and the
Excise Tax (including, without limitation, any interest or penalties on such taxes), results in the receipt by Executive, on an after-tax basis, of the greatest amount of payments and benefits provided for hereunder or otherwise, notwithstanding
that all or some portion of such Payments may be subject to the Excise Tax. Unless the Company and Executive otherwise agree in writing, any determination required under this Section shall be made by independent tax counsel designated by the
Company and reasonably acceptable to Executive (“Independent Tax Counsel’), whose determination shall be conclusive and binding upon Executive and the Company for all purposes. For purposes of making the calculations required
under this Section, Independent Tax Counsel may make reasonable assumptions and approximations concerning applicable taxes and may rely on reasonable, good faith interpretations concerning the application of Sections 280G and 4999 of the Code;
provided that Independent Tax Counsel shall assume that Executive pays all taxes at the highest marginal rate. The Company and Executive shall furnish to Independent Tax Counsel such information and documents as Independent Tax Counsel
may reasonably request in order to make a determination under this Section. The Company shall bear all costs that Independent Tax Counsel may reasonably incur in connection with any calculations contemplated by this Section. In the event
that Section 9(a)(ii)(B) above applies, then based on the information provided to Executive and the Company by Independent Tax Counsel, Executive may, in Executive’s sole discretion and within thirty (30) days of the date on which Executive is
provided with the information prepared by Independent Tax Counsel, determine which and how much of the Payments (including the accelerated vesting of equity compensation awards) to be otherwise received by Executive shall be eliminated or reduced
(as long as after such determination the value (as calculated by Independent Tax Counsel in accordance with the provisions of Sections 280G and 4999 of the Code) of the amounts payable or distributable to Executive equals the Reduced
Amount). If the Internal Revenue Service (the “IRS”) determines that any Payment is subject to the Excise Tax, then Section 9(b) hereof shall apply, and the enforcement of Section 9(b) shall be the exclusive remedy to the
Company. 
 (b) Adjustments. If, notwithstanding any reduction described in Section 9(a) hereof (or in the absence of any such
reduction), the IRS determines that Executive is liable for the Excise Tax as a result of the receipt of one or more Payments, then Executive shall be obligated to surrender or pay back to the Company, within one-hundred twenty (120) days after a
final IRS determination, an amount of such payments or benefits equal to the “Repayment Amount.” The Repayment Amount with respect to such Payments shall be the smallest such amount, if any, as shall be required to be
surrendered or paid to the Company so that Executive’s net proceeds with respect to such Payments (after taking into account the payment of the Excise Tax imposed on such Payments) shall be maximized. Notwithstanding the foregoing, the
Repayment Amount with respect to such Payments shall be zero (0) if a Repayment Amount of more than zero (0) would not eliminate the Excise Tax imposed on such Payments or if a 

  
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Repayment Amount of more than zero would not maximize the net amount received by Executive from the Payments. If the Excise Tax is not eliminated pursuant to this Section 9(b), Executive
shall pay the Excise Tax. 
 10. Miscellaneous Provisions. 

(a) Section 409A. To the extent (i) any payments to which Executive becomes entitled under this Agreement, or any agreement or
plan referenced herein, in connection with Executive’s termination of employment with the Company constitute deferred compensation subject to Section 409A of the Code and (ii) Executive is deemed at the time of such termination of employment to
be a “specified” employee under Section 409A of the Code, then such payment or payments shall not be made or commence until the earlier of (i) the expiration of the six (6)-month period measured from the Executive’s Separation; or
(ii) the date of Executive’s death following such Separation; provided, however, that such deferral shall only be effected to the extent required to avoid adverse tax treatment to Executive, including (without limitation) the additional
twenty percent (20%) tax for which Executive would otherwise be liable under Section 409A(a)(1)(B) of the Code in the absence of such deferral. Upon the expiration of the applicable deferral period, any payments which would have otherwise been
made during that period (whether in a single sum or in installments) in the absence of this paragraph shall be paid to Executive or Executive’s beneficiary in one lump sum (without interest). Except as otherwise expressly provided herein, to
the extent any expense reimbursement or the provision of any in-kind benefit under this Agreement (or otherwise referenced herein) is determined to be subject to (and not exempt from) Section 409A of the Code, the amount of any such expenses
eligible for reimbursement, or the provision of any in-kind benefit, in one calendar year shall not affect the expenses eligible for reimbursement or in kind benefits to be provided in any other calendar year, in no event shall any expenses be
reimbursed after the last day of the calendar year following the calendar year in which Executive incurred such expenses, and in no event shall any right to reimbursement or the provision of any in-kind benefit be subject to liquidation or exchange
for another benefit. To the extent that any provision of this Agreement is ambiguous as to its exemption or compliance with Section 409A, the provision will be read in such a manner so that all payments hereunder are exempt from Section 409A to the
maximum permissible extent, and for any payments where such construction is not tenable, that those payments comply with Section 409A to the maximum permissible extent. To the extent any payment under this Agreement may be classified as a
“short-term deferral” within the meaning of Section 409A, such payment shall be deemed a short-term deferral, even if it may also qualify for an exemption from Section 409A under another provision of Section 409A. Payments pursuant to
this Agreement (or referenced in this Agreement) are intended to constitute separate payments for purposes of Section 1.409A-2(b)(2) of the regulations under Section 409A. 

(b) Other Arrangements. This Agreement supersedes any and all cash severance arrangements and vesting acceleration arrangements on
change in control under any agreement governing Equity Awards, severance and salary continuation arrangements, programs and plans which were previously offered, or may be offered on the Effective Date or thereafter, by the Company to the Executive,
including change in control severance arrangements and vesting acceleration arrangements pursuant to an agreement governing Equity Awards, employment agreement or offer letter, and Executive hereby waives Executive’s rights to such other
benefits, provided that this Agreement shall not supersede the acceleration of vesting arrangements of any Pre-IPO Equity Awards (except as explicitly provided in Section 3(b)(iii) hereof). In no event shall any individual receive cash
severance benefits under both this Agreement and any other vesting acceleration arrangement, severance pay or salary continuation program, plan or other arrangement with the Company, provided that this Agreement shall not supersede the acceleration
of vesting arrangements of any Pre-IPO Equity Awards (except as explicitly provided in Section 3(b)(iii) hereof). For the avoidance of doubt, in no event shall Executive receive (i) payment under both Section 2 and Section 3 and/or (ii)
acceleration of Equity Award vesting under (a) both Section 2 and 3 or (b) any combination of (x) Section 3(b)(iii), (y) Section 3(b)(i) and/or Section 3(b)(ii) and/or (z) Section 3(b)(iv), as applicable, in each case with respect to
Executive’s Separation. 
 (c) Dispute Resolution. To ensure rapid and economical resolution of any and all disputes that
might arise in connection with this Agreement, Executive and the Company agree that any and all 

  
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disputes, claims, and causes of action, in law or equity, arising from or relating to this Agreement or its enforcement, performance, breach, or interpretation, will be resolved solely and
exclusively by final, binding, and confidential arbitration, by a single arbitrator, in San Diego County, and conducted by Judicial Arbitration & Mediation Services, Inc. (“JAMS”) under its then-existing employment rules and
procedures. Nothing in this section, however, is intended to prevent either party from obtaining injunctive relief in court to prevent irreparable harm pending the conclusion of any such arbitration. Each party to an arbitration or litigation
hereunder shall be responsible for the payment of its own attorneys’ fees. 
 (d) Notice. Notices and all other communications
contemplated by this Agreement shall be in writing and shall be deemed to have been duly given when personally delivered or when mailed by U.S. registered or certified mail, return receipt requested and postage prepaid or deposited with Federal
Express Corporation, with shipping charges prepaid. In the case of the Executive, mailed notices shall be addressed to him or her at the home address which he or she most recently communicated to the Company in writing. In the case of the
Company, mailed notices shall be addressed to its corporate headquarters, and all notices shall be directed to the attention of its Secretary. 

(e) Waiver. No provision of this Agreement shall be modified, waived or discharged unless the modification, waiver or discharge is
agreed to in writing and signed by the Executive and by an authorized officer of the Company (other than the Executive). No waiver by either party of any breach of, or of compliance with, any condition or provision of this Agreement by the
other party shall be considered a waiver of any other condition or provision or of the same condition or provision at another time. 
 (f)
Withholding Taxes. All payments made under this Agreement shall be subject to reduction to reflect taxes or other charges required to be withheld by law. 

(g) Severability. The invalidity or unenforceability of any provision or provisions of this Agreement shall not affect the validity or
enforceability of any other provision hereof, which shall remain in full force and effect. 
 (h) No Retention Rights. Nothing
in this Agreement shall confer upon the Executive any right to continue in service for any period of specific duration or interfere with or otherwise restrict in any way the rights of the Company or any subsidiary of the Company or of the Executive,
which rights are hereby expressly reserved by each, to terminate his or her service at any time and for any reason, with or without Cause. 

(i) Choice of Law. The validity, interpretation, construction and performance of this Agreement shall be governed by the laws of the
State of California (other than its choice-of-law provisions). 

  
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 IN WITNESS WHEREOF, each of the parties has executed this Agreement, in the case of the Company
by its duly authorized officer, as of the day and year first above written. 
  

					
	EXECUTIVE	 		 	OBALON THERAPEUTICS, INC.
			
	  
	 		 	  

	[Name]	 		 	By:
		 		 	Title:


  
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 EXHIBIT A 

GENERAL RELEASE OF ALL CLAIMS AND COVENANT NOT TO SUE 

This General Release of All Claims and Covenant Not to Sue (the “ Release”) is entered into between [Name] (“Executive”)
and Obalon Thereapeutics, Inc. (the “Company”) (collectively, “the parties”). 
 WHEREAS, on
                    , Executive and the Company entered into a Retention Agreement with the Company (the “Retention Agreement,” to which
this Release is attached as Exhibit A); 
 WHEREAS, on
                    , Executive’s employment with the Company terminated (the “Separation Date”); 

WHEREAS, this agreement serves as the Release, pursuant to the Retention Agreement; and 

WHEREAS, Executive and the Company desire to mutually, amicably and finally resolve and compromise all issues and claims surrounding
Executive’s employment and separation from employment with the Company; 
 NOW THEREFORE, in consideration for the mutual
promises and undertakings of the parties as set forth below, Executive and the Company hereby enter into this Release. 
 1.
Acknowledgment of Payment of Wages: By his signature below, Executive acknowledges that, on the Separation Date, the Company paid him for all wages, salary, bonuses, commissions, reimbursable expenses, accrued but unused vacation and any
similar payments due him from the Company as of the Separation Date. By signing below, Executive acknowledges that the Company does not owe him any other amounts, except as may become payable under the Retention Agreement and the Release. 

2. Return of Company Property: Executive hereby warrants to the Company that he has returned to the Company all property or data of the
Company of any type whatsoever that has been in his possession, custody or control. 
 3. Consideration: In exchange for
Executive’s agreement to this Release and his other promises in the Retention Agreement and herein, and pursuant to the Retention Agreement, the Company agrees to provide Executive with the consideration set forth in
Section      of the Retention Agreement. By signing below, Executive acknowledges that he is receiving the consideration in exchange for waiving his rights to claims referred to in this Release.

4. General Release and Waiver of Claims:

a. The payments and promises set forth in this Release are in full satisfaction of all accrued salary, vacation pay, bonus and commission pay,
profit-sharing, stock, stock options, restricted stock units or other ownership interest in the Company, termination benefits or other compensation to which Executive may be entitled by virtue of his
employment with the Company or his separation from the Company, including pursuant to the Retention Agreement. To the fullest extent permitted by law, Executive hereby releases and waives any other claims he may have against the Company and its
owners, agents, officers, shareholders, employees, directors, attorneys, subscribers, subsidiaries, affiliates, successors and assigns (collectively “Releasees”), whether known or not known, including, without limitation, claims under any
employment laws, including, but not limited to, claims of unlawful discharge, breach of contract, breach of the covenant of good faith and fair dealing, fraud, violation of public policy, defamation, physical injury, emotional distress, claims for
additional compensation or benefits arising out of his employment or separation of employment, including pursuant to the Offer Letter, claims under Title VII of the 1964 Civil Rights Act, as amended, the California Fair Employment and Housing Act
and any other laws and/or regulations relating to employment or employment discrimination, including, without limitation, claims based on age or under the Age Discrimination in Employment Act or Older Workers Benefit Protection Act, and/or claims
based on disability or under the Americans with Disabilities Act. 

  
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 b. By signing below, Executive expressly waives any benefits of Section 1542 of the Civil Code of
the State of California, which provides as follows: 
 “A GENERAL RELEASE DOES NOT EXTEND TO CLAIMS WHICH THE CREDITOR DOES NOT KNOW OR
SUSPECT TO EXIST IN HIS FAVOR AT THE TIME OF EXECUTING THE RELEASE, WHICH IF KNOWN BY HIM MUST HAVE MATERIALLY AFFECTED HIS SETTLEMENT WITH THE DEBTOR.” 

c. Executive and the Company do not intend to release claims that he may not release as a matter of law, including but not limited to claims
for indemnity under California Labor Code Section 2802, or any claims for enforcement of this Release. To the fullest extent permitted by law, any dispute regarding the scope of this general release shall be determined by an arbitrator under
the procedures set forth in the Dispute Resolution section set forth in the Retention Agreement. 
 5. Covenant Not to Sue:

a. To the fullest extent permitted by law, at no time subsequent to the execution of this Release will Executive pursue, or cause or knowingly
permit the prosecution, in any state, federal or foreign court, or before any local, state, federal or foreign administrative agency, or any other tribunal, of any charge, claim or action of any kind, nature and character whatsoever, known or
unknown, which he may now have, have ever had, or may in the future have against Releasees, which is based in whole or in part on any matter released by this Release.

b. Nothing in this paragraph shall prohibit Executive from filing a charge or complaint with a government agency where, as a matter of law,
the parties may not restrict his right to file such administrative complaints. However, Executive understands and agrees that, by entering into this Release, he is releasing any and all individual claims for relief, and that any and all
subsequent disputes between Executive and the Company shall be resolved through arbitration as provided in the Retention Agreement. 
 c.
Nothing in this paragraph shall prohibit or impair Executive or the Company from complying with all applicable laws, nor shall this Release be construed to obligate either party to commit (or aid or abet in the commission of) any unlawful act. 

6. Review of Release: Executive understands that he may take up to twenty-one (21) days to consider this Release and, by signing below,
affirms that he was advised to consult with an attorney prior to signing this Release. Executive also understands that he may revoke this Release within seven (7) days of signing this document and that the consideration to be provided to him
pursuant to Paragraph 2(c) of the Retention Agreement will be provided only at the end of that seven (7) day revocation period. 
 7.
Effective Date: This Release is effective on the eighth (8th) day after Executive signs it, provided he has not revoked it as of that time.

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 8. Other Terms of Retention Agreement Incorporated Herein: All other terms of the
Retention Agreement to the extent not inconsistent with the terms of this Release are hereby incorporated in this Release as though fully stated herein and apply with equal force to this Release, including, without limitation, the provisions on
Non-Competition, Cooperation and Non-Disparagement, Section 409A, Dispute Resolution and Choice of Law. 
  

							
	Dated:	 	  
	 		 	  

		 		 		 	Name:
		 		 		 	Title:
		 		 		 	For the Company
				
	Dated:	 	  
	 		 	  

		 		 		 	Name:


  
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