SEC Form 4 · accession 0001235802-17-000146
ENTELLUS MEDICAL INC · ENTL
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Stephen R Paidosh
Officer — Vice President, Operations
Period of report
Sep 13, 2017
Accepted (ET)
Sep 14, 2017 · 4:08 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001374128
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock, $0.001 par valueF1 | Sep 13, 2017 | M | 25,000 | $1.40 | A | 32,500 | D | |
| Common Stock, $0.001 par valueF2,F1 | Sep 13, 2017 | S | 25,000 | $17.54 | D | 7,500 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (right to buy)F3 | $1.40 | Sep 13, 2017 | M | 25,000 | D | — | Dec 17, 2017 | Common Stock | 25,000 | 0 | D |
Explanation of responses
- F1Includes 7,500 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.
- F2The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $17.50 to $17.60, 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 sold at each separate price within the ranges set forth in this footnote (2) to this Form 4.
- F3The option became fully vested on December 17, 2011.