SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Pinto Cynthia Buch

(Last) (First) (Middle)
2 MUSICK

(Street)
IRVINE CA 92618

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
07/01/2020
3. Issuer Name and Ticker or Trading Symbol
ENDOLOGIX INC /DE/ [ ELGX ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Interim CFO
5. If Amendment, Date of Original Filed (Month/Day/Year)
07/10/2020
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 19,198(1) D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Option to Purchase 12/30/2019 12/30/2028 Common Stock 12,255(2) $7.45 D
Option to Purchase 09/05/2019 08/05/2029 Common Stock 15,867(3) $6.67 D
Option to Purchase 09/10/2020 09/10/2026 Common Stock 1,572(4) $4.71 D
Explanation of Responses:
1. On July 10, 2020, the reporting person filed a Form 3 which inadvertently reported 24,549 shares beneficially owned. In fact, as reported in this amendment, the reporting person had 19,198 shares beneficially owned as of the report date, July 1, 2020.
2. 100% of the option award vested on December 30, 2019.
3. Options vest ratably over thirty-six months.
4. The reporting person received this stock option pursuant to the option exchange program. The options vest in three equal annual installments over a three-year period commencing on September 10, 2019.
Remarks:
Cynthia Buch Pinto by Timothy N. Brady Attorney-in-Fact for Reporting Person 08/14/2020
** 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 5 (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.