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