SEC Form 4 · accession 0001235802-18-000008
ENTELLUS MEDICAL INC · ENTL
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Michael Harry Rosenthal
Officer — Chief Operating Officer
Period of report
Nov 4, 2017
Accepted (ET)
Jan 9, 2018 · 4:25 pm EST
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,F2 | Nov 4, 2017 | A | 10,000 | $0.00 | A | 30,000 | 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 | $17.24 | Nov 4, 2017 | A | 20,000 | A | — | Nov 4, 2027 | Common Stock | 20,000 | 20,000 | D |
Explanation of responses
- F1These shares will be issued over time upon vesting pursuant to a restricted stock unit granted under the Entellus Medical, Inc. 2015 Incentive Award Plan.
- F2Includes 30,000 shares that will be issued over time upon vesting pursuant to restricted stock units granted under the Entellus Medical, Inc. 2015 Incentive Award Plan.
- F3This option vests with respect to 1/48th of the shares on December 1, 2017 and on each monthly anniversary of November 1, 2017 thereafter, subject to such Reporting Person's continued employment with Entellus Medical, Inc.