SEC Form 4 · accession 0001235802-18-000010
ENTELLUS MEDICAL INC · ENTL
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Thomas P. Williamson
Officer — VP, Commercial Operations
Period of report
Nov 4, 2017
Accepted (ET)
Jan 9, 2018 · 4:45 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 | 47,217 | D | |
| Common Stock, $0.001 par valueF4 | Jan 5, 2018 | S | 968 | $24.01 | D | 46,467 | D | |
| Common Stock, $0.001 par valueF4 | Jan 8, 2018 | S | 1,481 | $24.12 | D | 44,986 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Non-Statutory Stock Option (right to buy)F5 | $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 35,886 shares that will be issued over time upon vesting pursuant to restricted stock units granted under the Entellus Medical, Inc. 2015 Incentive Award Plan and an aggregate of 446 shares acquired under the Entellus Medical, Inc. 2015 Employee Stock Purchase Plan on June 30, 2016, December 31, 2016 and June 30, 2017.
- F3These 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.
- F4Includes 27,943 shares will be issued over time upon vesting pursuant to restricted stock units granted under the Entellus Medical, Inc. 2015 Incentive Award Plan and an aggregate of 664 shares acquired under the Entellus Medical, Inc. 2015 Employee Stock Purchase Plan on June 30, 2016, December 31, 2016, June 30, 2017 and December 31, 2017.
- F5This 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.