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Filing Details

Accession Number:: 0001209191-15-009483
Form Type:: 4
Zero Holdings:: No
Publication Time:: 2015-02-04 16:58:42
Reporting Period:: 2015-02-03

Filing Date:: 2015-02-04
Accepted Time:: 2015-02-04 16:58:42
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
1172861	International Life Sciences Fund Iii (Lp1), L.p.	One Boston Place, Suite 3900 201 Washington Street Boston MA 02108	No	No	Yes	No
1233226	International Life Sciences Fund Iii Strategic Partners, L.p.	One Boston Place, Suite 3900 201 Washington Street Boston MA 02108	No	No	Yes	No
1233315	International Life Sciences Fund Iii Co-Investment, L.p.	One Boston Place, Suite 3900 201 Washington Street Boston MA 02108	No	No	Yes	No
1367381	Sv Life Sciences Fund Iv, L.p.	One Boston Place, Suite 3900 201 Washington Street Boston MA 02108	No	No	Yes	No
1392309	Sv Life Sciences Fund Iv Strategic Partners, L. P.	One Boston Place, Suite 3900 201 Washington Street Boston MA 02108	No	No	Yes	No
1422339	Svlsf Iv, Llc	One Boston Place, Suite 3900 201 Washington Street Boston MA 02108	No	No	Yes	No
1422340	Sv Life Sciences Fund Iv (Gp), L.p.	One Boston Place, Suite 3900 201 Washington Street Boston MA 02108	No	No	Yes	No
1630790	International Life Sciences Fund Iii (Gp), L.p.	One Boston Place, Suite 3900 201 Washington Street Boston MA 02108	No	No	Yes	No
1630791	Ilsf Iii, Llc	One Boston Place, Suite 3900 201 Washington Street Boston MA 02108	No	No	Yes	No

Reported Non-Derivative Transactions

Show Other Fields >>

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	1,311,597	$0.00	1,311,597	No	4	C	Indirect	By ILSF LP1
Common Stock	Acquisiton	2015-02-03	15,562	$0.00	15,562	No	4	C	Indirect	By ILSF Co-Invest
Common Stock	Acquisiton	2015-02-03	12,529	$0.00	12,529	No	4	C	Indirect	By ILSF Strategic
Common Stock	Acquisiton	2015-02-03	1,781,615	$0.00	1,781,615	No	4	C	Indirect	By Fund IV
Common Stock	Acquisiton	2015-02-03	308,878	$17.00	2,090,493	No	4	P	Indirect	By Fund IV
Common Stock	Acquisiton	2015-02-03	50,581	$0.00	50,581	No	4	C	Indirect	By Fund IV Strategic
Common Stock	Acquisiton	2015-02-03	8,769	$17.00	59,350	No	4	P	Indirect	By Fund IV Strategic

Equity Swap Involved	Form Type	Code	Nature of Ownership	Explanation
No	4	C	Indirect	By ILSF LP1
No	4	C	Indirect	By ILSF Co-Invest
No	4	C	Indirect	By ILSF Strategic
No	4	C	Indirect	By Fund IV
No	4	P	Indirect	By Fund IV
No	4	C	Indirect	By Fund IV Strategic
No	4	P	Indirect	By Fund IV Strategic

Reported Derivative Transactions

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Sec. Name	Sec. Type	Acquisiton - Disposition	Date	Amount	Price	Amount - 2	Price - 2
Common Stock	Series A Convertible Preferred Stock	Disposition	2015-02-03	1,174,836	$0.00	293,709	$0.00
Common Stock	Series A Convertible Preferred Stock	Disposition	2015-02-03	13,940	$0.00	3,485	$0.00
Common Stock	Series A Convertible Preferred Stock	Disposition	2015-02-03	11,224	$0.00	2,806	$0.00
Common Stock	Series B Convertible Preferred Stock	Disposition	2015-02-03	2,434,052	$0.00	608,513	$0.00
Common Stock	Series B Convertible Preferred Stock	Disposition	2015-02-03	28,882	$0.00	7,220	$0.00
Common Stock	Series B Convertible Preferred Stock	Disposition	2015-02-03	23,254	$0.00	5,813	$0.00
Common Stock	Series C Convertible Preferred Stock	Disposition	2015-02-03	1,213,172	$0.00	409,375	$0.00
Common Stock	Series C Convertible Preferred Stock	Disposition	2015-02-03	14,395	$0.00	4,857	$0.00
Common Stock	Series C Convertible Preferred Stock	Disposition	2015-02-03	11,590	$0.00	3,910	$0.00
Common Stock	Series D Convertible Preferred Stock	Disposition	2015-02-03	2,977,679	$0.00	744,419	$0.00
Common Stock	Series D Convertible Preferred Stock	Disposition	2015-02-03	84,539	$0.00	21,134	$0.00
Common Stock	Series E Convertible Preferred Stock	Disposition	2015-02-03	4,148,785	$0.00	1,037,196	$0.00
Common Stock	Series E Convertible Preferred Stock	Disposition	2015-02-03	117,788	$0.00	29,447	$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
No	4	C	Indirect
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 A, B, C, D and E Convertible Preferred Stock (collectively, the "Preferred Stock") has no expiration date.
The Preferred Stock converted into shares (the "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 A, B, D and E Convertible Preferred Stock from 1-for-1 to 0.25-for-1 and, for the Series C Convertible Preferred Stock, from 1.3498-for-1 to an approximate 0.3374-for-1 basis (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).
International Life Sciences Fund III (GP), L.P. ("Fund III GP") is the general partner of each of: (i) International Life Sciences Fund III (LP1), L.P. ("ILSF LP1"), (ii) International Life Sciences Fund III Co-Investment, L.P. ("ILSF Co-Invest") and (iii) International Life Sciences Fund III Strategic Partners, L.P. ("ILSF Strategic" and collectively, the "Fund III Entities"). ILSF III, LLC (the "ILSF General Partner") is the general partner of Fund III GP and, through an investment committee comprised of James Garvey, Kate Bingham, Eugene D. Hill, III and Michael Ross controls voting and investment decisions over the Issuer's shares held by the Fund III Entities by majority vote.
Each member of the investment committee of ILSF General Partner disclaims beneficial ownership over the Shares held by the Fund III Entities except to the extent of any pecuniary interest therein. Each of ILSF General Partner and Fund III GP disclaim beneficial ownership over the Shares held by the Fund III Entities except to the extent of their respective pecuniary interest therein.
SV Life Sciences Fund IV (GP), L.P. ("Fund IV GP") is the general partner of each of SV Life Sciences Fund IV, L.P. ("Fund IV") and SV Life Sciences Fund IV Strategic Partners, L.P. ("Fund IV Strategic" and together with Fund IV, the "Fund IV Entities"). SVLSF IV, LLC (the "SVLS General Partner") is the general partner of Fund IV GP and, through an investment committee comprised of David Milne (also a member of the Issuer's board of directors), James Garvey, Kate Bingham, Eugene D. Hill, III and Michael Ross controls voting and investment decisions over the Issuer's shares held by the Fund IV Entities by a majority vote.
Each member of the investment committee of SVLS General Partner disclaims beneficial ownership over the Shares held by the Fund IV Entities except to the extent of any pecuniary interest therein. Each of SVLS General Partner and Fund IV GP disclaim beneficial ownership over the Shares held by the Fund IV Entities except to the extent of their respective pecuniary interest therein.