0001235802-17-000160.txt : 20171018
0001235802-17-000160.hdr.sgml : 20171018
20171018192051
ACCESSION NUMBER: 0001235802-17-000160
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20171016
FILED AS OF DATE: 20171018
DATE AS OF CHANGE: 20171018
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: MENSINK KEVIN L
CENTRAL INDEX KEY: 0001626343
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36814
FILM NUMBER: 171143484
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
2017-10-16
0
0001374128
ENTELLUS MEDICAL INC
ENTL
0001626343
MENSINK KEVIN L
C/O ENTELLUS MEDICAL, INC.
3600 HOLLY LANE NORTH, SUITE 40
PLYMOUTH
MN
55447
0
1
0
0
VP Marketing
Common Stock, $0.001 par value
2017-10-16
4
M
0
10000
1.24
A
17500
D
Common Stock, $0.001 par value
2017-10-16
4
S
0
10000
18.2903
D
7500
D
Stock Option (right to buy)
1.24
2017-10-16
4
M
0
10000
1.24
D
2023-04-08
Common Stock
10000
61400
D
Includes 7,500 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.
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 $18.25 to $18.64, 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 (3) to this Form 4.
This option vested as to twenty-five percent (25%) of the shares underlying the option on April 8, 2014, with the remaining shares vesting in 36 substantially equal monthly installments on each monthly anniversary of the grant date thereafter, subject to continued employment or service with the Issuer through each applicable vesting date.
/s/ Brent Moen, attorney-in-fact
2017-10-18