0001235802-17-000084.txt : 20170614
0001235802-17-000084.hdr.sgml : 20170614
20170614170007
ACCESSION NUMBER: 0001235802-17-000084
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170613
FILED AS OF DATE: 20170614
DATE AS OF CHANGE: 20170614
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: ENTELLUS MEDICAL INC
CENTRAL INDEX KEY: 0001374128
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 204627978
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 3600 HOLLY LANE NORTH
STREET 2: SUITE 40
CITY: PLYMOUTH
STATE: MN
ZIP: 55447
BUSINESS PHONE: 763-463-1595
MAIL ADDRESS:
STREET 1: 3600 HOLLY LANE NORTH
STREET 2: SUITE 40
CITY: PLYMOUTH
STATE: MN
ZIP: 55447
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: NEELS GUIDO J
CENTRAL INDEX KEY: 0001222362
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36814
FILM NUMBER: 17911711
MAIL ADDRESS:
STREET 1: C/O GUIDANT CORP
STREET 2: 111 MONUMENT CIRCLE #2900
CITY: INDIANAPOLIS
STATE: IN
ZIP: 46204-5129
4
1
primary_doc.xml
PRIMARY DOCUMENT
X0306
4
2017-06-13
0
0001374128
ENTELLUS MEDICAL INC
ENTL
0001222362
NEELS GUIDO J
3600 HOLLY LANE NORTH, SUITE 40
PLYMOUTH
MN
55447
1
0
0
0
Common Stock, $0.001 par value
2017-06-13
4
A
0
2500
0
A
17500
D
Stock Option (right to buy)
13.38
2017-06-13
4
A
0
5000
0
A
2027-06-13
Common Stock
5000
5000
D
Includes 2,500 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.
This option vests in full on the earlier to occur of June 13, 2018 and the date of the Company's annual meeting of stockholders immediately following June 13, 2017, subject to the Reporting Person's continued service with the Company through the applicable vesting date.
/s/ Jonelle R. Burnham, attorney-in-fact
2017-06-14