0001235802-18-000009.txt : 20180109 0001235802-18-000009.hdr.sgml : 20180109 20180109163254 ACCESSION NUMBER: 0001235802-18-000009 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180105 FILED AS OF DATE: 20180109 DATE AS OF CHANGE: 20180109 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: 18519438 MAIL ADDRESS: STREET 1: 11625 26TH AVE. NORTH CITY: PLYMOUTH STATE: MN ZIP: 55441 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 2018-01-05 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 2018-01-05 4 S 0 3471 24.01 D 53199 D These shares were sold under a pre-arranged sales instruction pursuant to Rule 10b5-1 under the Securities Exchange Act of 1934, as amended, to cover the estimated tax withholding obligations in connection with the vesting of restricted stock units. Includes 28,500 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 and an aggregate of 2,788 shares acquired under the Entellus Medical, Inc. 2015 Employee Stock Purchase Plan on June 30, 2016 and June 30, 2017. /s/ Brent Moen, attorney-in-fact 2018-01-09