0001570562-18-000130.txt : 20181217 0001570562-18-000130.hdr.sgml : 20181217 20181217215135 ACCESSION NUMBER: 0001570562-18-000130 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20181214 FILED AS OF DATE: 20181217 DATE AS OF CHANGE: 20181217 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: GILL DAVID N CENTRAL INDEX KEY: 0001106519 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38381 FILM NUMBER: 181239290 MAIL ADDRESS: STREET 1: C/O NXSTAGE MEDICAL INC. (NXTM) STREET 2: 439 SOUTH UNION STREET, 5TH FLOOR CITY: LAWRENCE STATE: MA ZIP: 01843 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Evolus, Inc. CENTRAL INDEX KEY: 0001570562 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 461385614 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 520 NEWPORT CENTER DRIVE STREET 2: SUITE 1200 CITY: NEWPORT BEACH STATE: CA ZIP: 92660 BUSINESS PHONE: (949) 284-4555 MAIL ADDRESS: STREET 1: 520 NEWPORT CENTER DRIVE STREET 2: SUITE 1200 CITY: NEWPORT BEACH STATE: CA ZIP: 92660 4 1 wf-form4_154510147610889.xml FORM 4 X0306 4 2018-12-14 0 0001570562 Evolus, Inc. EOLS 0001106519 GILL DAVID N 520 NEWPORT CENTER DR. SUITE 1200 NEWPORT BEACH CA 92660 1 0 0 0 Common Stock 2018-12-14 4 P 0 3000 12.7667 A 3000 D The shares were purchased in multiple trades at prices ranging from $12.72 to $12.84. The price reported above reflects the weighted average purchase price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected. /s/ Jeffrey J. Plumer, as attorney-in-fact for David N. Gill 2018-12-17