SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
X
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Accelmed Growth Partners, L.P.

(Last) (First) (Middle)
C/O ACCELMED GROWTH PARTNERS MANAGEMENT
6 HACHOSHLIM STREET, 6TH FLOOR

(Street)
HERZLIYA PITUACH L3 46120

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
COGENTIX MEDICAL INC /DE/ [ CGNT ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
04/20/2018
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock, $0.01 par value per share 04/20/2018 U 16,129,033(1) D $3.85 0 D(2)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
1. Name and Address of Reporting Person*
Accelmed Growth Partners, L.P.

(Last) (First) (Middle)
C/O ACCELMED GROWTH PARTNERS MANAGEMENT
6 HACHOSHLIM STREET, 6TH FLOOR

(Street)
HERZLIYA PITUACH L3 46120

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Accelmed Growth Partners (GP), L.P.

(Last) (First) (Middle)
C/O ACCELMED GROWTH PARTNERS, L.P.
6 HACHOSHLIM STREET, 6TH FLOOR

(Street)
HERZLIYA PITUACH L3 46120

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Accelmed Growth Partners (AGP) Ltd

(Last) (First) (Middle)
C/O ACCELMED GROWTH PARTNERS, L.P.
6 HACHOSHLIM STREET, 6TH FLOOR

(Street)
HERZLIYA PITUACH L3 46120

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Accelmed Growth Partners Management Ltd.

(Last) (First) (Middle)
C/O ACCELMED GROWTH PARTNERS, L.P.
6 HACHOSHLIM STREET, 6TH FLOOR

(Street)
HERZLIYA PITUACH L3 46120

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
1. On April 20, 2018, these shares were purchased in a tender offer for all of the issued and outstanding shares of common stock, par value $0.01 per share, of Cogentix Medical, Inc. (the Company") by Camden Merger Sub, Inc. ("Merger Sub"), a wholly owned subsidiary of LM US Parent, Inc. and Laborie Medical Technologies Canada ULC, pursuant to the Agreement and Plan of Merger dated as of March 11, 2018 (the "Merger Agreement").
2. These shares are held directly by Accelmed Growth Partners, L.P. and may be deemed to be beneficially owned indirectly by (i) Accelmed Growth Partners (GP), L.P., the general partner of Accelmed Growth Partners, L.P., (ii) Accelmed Growth Partners (AGP) Limited, the general partner of Accelmed Growth Partners (GP), L.P., and (iii) Accelmed Growth Partners Management Ltd., which has certain voting and dispositive power over the shares pursuant to a management agreement. Each of Accelmed Growth Partners (GP), L.P., Accelmed Growth Partners (AGP) Limited, and Accelmed Growth Partners Management Ltd. disclaims such beneficial ownership except to the extent of its pecuniary interest in the shares.
/s/ Accelmed Growth Partners, L.P. By: Accelmed Growth Partners (GP), L.P., its general partner By: Accelmed Growth Partners (AGP) Ltd., its general partner By Uri Geiger, Managing Partner 04/23/2018
/s/ Accelmed Growth Partners (GP), L.P. By: Accelmed Growth Partners (AGP) Ltd., its general partner By: Uri Geiger, Managing Partner 04/23/2018
/s/ Accelmed Growth Partners (AGP) Ltd. By: Uri Geiger, Managing Partner 04/23/2018
/s/ Accelmed Growth Partners Management Ltd. By: Uri Geiger, Managing Partner 04/23/2018
** 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 4 (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.