0001235802-17-000158.txt : 20171011 0001235802-17-000158.hdr.sgml : 20171011 20171011160847 ACCESSION NUMBER: 0001235802-17-000158 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171009 FILED AS OF DATE: 20171011 DATE AS OF CHANGE: 20171011 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: PETERSON KAREN E CENTRAL INDEX KEY: 0001625112 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36814 FILM NUMBER: 171132732 MAIL ADDRESS: STREET 1: C/O ENTELLUS MEDICAL, INC. STREET 2: 3600 HOLLY LANE NORTH, SUITE 40 CITY: PLYMOUTH STATE: MN ZIP: 55447 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ENTELLUS MEDICAL INC CENTRAL INDEX KEY: 0001374128 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 204627978 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3600 HOLLY LANE NORTH STREET 2: SUITE 40 CITY: PLYMOUTH STATE: MN ZIP: 55447 BUSINESS PHONE: 763-463-1595 MAIL ADDRESS: STREET 1: 3600 HOLLY LANE NORTH STREET 2: SUITE 40 CITY: PLYMOUTH STATE: MN ZIP: 55447 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2017-10-09 0 0001374128 ENTELLUS MEDICAL INC ENTL 0001625112 PETERSON KAREN E C/O ENTELLUS MEDICAL, INC. 3600 HOLLY LANE NORTH, SUITE 40 PLYMOUTH MN 55447 0 1 0 0 VP, Regulatory and Quality Common Stock, $0.001 par value 2017-10-09 4 S 0 650 20.1692 D 32734 D These shares were sold under a pre-arranged sales plan pursuant to Rule 10b5-1 under the Securities Exchange Act of 1934, as amended. The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $20.10 to $20.20, inclusive. The reporting person undertakes to provide to Entellus Medical, Inc., any security holder of Entellus Medical, Inc., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth in this footnote (2) to this Form 4. Includes 10,000 shares that will be issued over time upon vesting pursuant to a restricted stock unit granted under the Entellus Medical, Inc. 2015 Incentive Award Plan. /s/ Brent Moen, attorney-in-fact 2017-10-11