0001235802-17-000049.txt : 20170508 0001235802-17-000049.hdr.sgml : 20170508 20170508174923 ACCESSION NUMBER: 0001235802-17-000049 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170508 FILED AS OF DATE: 20170508 DATE AS OF CHANGE: 20170508 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WHITE ROBERT S. CENTRAL INDEX KEY: 0001571208 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36814 FILM NUMBER: 17823699 MAIL ADDRESS: STREET 1: 11625 26TH AVE. NORTH CITY: PLYMOUTH STATE: MN ZIP: 55441 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2017-05-08 0 0001374128 ENTELLUS MEDICAL INC ENTL 0001571208 WHITE ROBERT S. 3600 HOLLY LANE NORTH, SUITE 40 PLYMOUTH MN 55447 1 1 0 0 President and CEO Common Stock, $0.001 par value 2017-05-08 4 P 0 10000 12.24 A 55353 D The price reported in Column 4 is a weighted average price. These shares were purchased in multiple transactions at prices ranging from $11.70 to $12.25, 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 purchased at each separate price within the ranges set forth in this footnote (1) to this Form 4. Includes 38,000 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. Includes 1,471 shares acquired under the Entellus Medical, Inc. 2015 Employee Stock Purchase Plan on June 30, 2016. /s/ Brent Moen, attorney-in-fact 2017-05-08