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Filing Details

Accession Number:: 0001209191-15-009475
Form Type:: 4
Zero Holdings:: No
Publication Time:: 2015-02-04 16:54:32
Reporting Period:: 2015-02-03

Filing Date:: 2015-02-04
Accepted Time:: 2015-02-04 16:54:32
SEC Url:: Form 4 Filing

Issuer

Cik	Name	Symbol	Sector (SIC)	IRS No
1374128	Entellus Medical Inc	ENTL	Surgical & Medical Instruments & Apparatus (3841)	204627978

Insiders

Cik	Name	Reported Address	Director	Officer	Large Shareholder	Other
1428991	Essex Woodlands Health Ventures Fund Viii-A Lp	21 Waterway Avenue, Suite 225 The Woodlands TX 77380	No	No	Yes	No
1428992	Essex Woodlands Health Ventures Fund Viii Lp	21 Waterway Avenue, Suite 225 The Woodlands TX 77380	No	No	Yes	No
1452935	Essex Woodlands Health Ventures Fund Viii-B Lp	21 Waterway Avenue, Suite 225 The Woodlands TX 77380	No	No	Yes	No
1632026	Essex Woodlands Health Ventures Viii, L.p.	21 Waterway Avenue, Suite 225 The Woodlands TX 77380	No	No	Yes	No
1632027	Essex Woodlands Health Ventures Viii, L.l.c.	21 Waterway Avenue, Suite 225 The Woodlands TX 77380	No	No	Yes	No

Reported Non-Derivative Transactions

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Sec. Name	Acquisiton - Disposition	Date	Amount	Price	Remaning Holdings	Equity Swap Involved	Form Type	Code	Nature of Ownership	Explanation
Common Stock	Acquisiton	2015-02-03	3,135,858	$0.00	3,135,858	No	4	C	Indirect	By Fund VIII
Common Stock	Acquisiton	2015-02-03	319,853	$17.00	3,455,711	No	4	P	Indirect	By Fund VIII
Common Stock	Acquisiton	2015-02-03	226,095	$0.00	226,095	No	4	C	Indirect	By Fund VIII-A
Common Stock	Acquisiton	2015-02-03	23,061	$17.00	249,156	No	4	P	Indirect	By Fund VIII-A
Common Stock	Acquisiton	2015-02-03	98,302	$0.00	98,302	No	4	C	Indirect	By Fund VIII-B
Common Stock	Acquisiton	2015-02-03	10,027	$17.00	108,329	No	4	P	Indirect	By Fund VIII-B

Equity Swap Involved	Form Type	Code	Nature of Ownership	Explanation
No	4	C	Indirect	By Fund VIII
No	4	P	Indirect	By Fund VIII
No	4	C	Indirect	By Fund VIII-A
No	4	P	Indirect	By Fund VIII-A
No	4	C	Indirect	By Fund VIII-B
No	4	P	Indirect	By Fund VIII-B

Reported Derivative Transactions

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Sec. Name	Sec. Type	Acquisiton - Disposition	Date	Amount	Price	Amount - 2	Price - 2
Common Stock	Series D Convertible Preferred Stock	Disposition	2015-02-03	8,325,325	$0.00	2,081,331	$0.00
Common Stock	Series D Convertible Preferred Stock	Disposition	2015-02-03	600,259	$0.00	150,064	$0.00
Common Stock	Series D Convertible Preferred Stock	Disposition	2015-02-03	260,982	$0.00	65,245	$0.00
Common Stock	Series E Convertible Preferred Stock	Disposition	2015-02-03	4,218,108	$0.00	1,054,527	$0.00
Common Stock	Series E Convertible Preferred Stock	Disposition	2015-02-03	304,126	$0.00	76,031	$0.00
Common Stock	Series E Convertible Preferred Stock	Disposition	2015-02-03	132,228	$0.00	33,057	$0.00

Equity Swap Involved	Transaction Form Type	Transaction Code	Nature of Ownership
No	4	C	Indirect
No	4	C	Indirect
No	4	C	Indirect
No	4	C	Indirect
No	4	C	Indirect
No	4	C	Indirect

Footnotes

Series D and E Convertible Preferred Stock (collectively, the "Preferred Stock") has no expiration date. The Preferred Stock converted into shares of Issuer common stock upon the closing of the Issuer's initial public offering, giving effect to the 1-for-4 reverse stock split effected by the Issuer on January 12, 2015, which changed the conversion rate for the Series D and E Convertible Preferred Stock from 1-for-1 to 0.25-for-1 (subject to the payment of cash, or the rounding up by a maximum of one share, for any fractional shares, in accordance with the Issuer's certificate of incorporation).
Essex Woodlands Health Ventures VIII, L.P. (the "Essex Funds GP"), is the general partner of each of Essex Woodlands Health Ventures Fund VIII, L.P. ("Fund VIII"), Essex Woodlands Health Ventures Fund VIII-A, L.P. ("Fund VIII-A") and Essex Woodlands Health Ventures Fund VIII-B, L.P. ("Fund VIII-B", and together with Fund VIII and Fund VIII-A, the "Essex Funds"). Essex Woodlands Health Ventures VIII, L.L.C. (the "General Partner") is the general partner of the Essex Funds GP. The General Partner holds sole voting and dispositive power over the shares held by each of the Essex Funds (the "Shares"). The managers of the General Partner are James L. Currie, Martin P. Sutter, Immanuel Thangaraj, Ron Eastman, Guido Neels (also a member of the Issuer's board of directors), Petri Vainio, Jeff Himawan and Steve Wiggins (collectively, the "Managers"), and may exercise voting and investment control over the Shares by the majority action of the Managers.
Each individual Manager and the General Partner disclaims beneficial ownership over the Shares except to the extent of his or its respective pecuniary interest therein.