Initial Statement of Beneficial Ownership (3)
2020年7月11日 - 5:13AM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
Pinto Cynthia Buch |
2. Date of Event Requiring Statement (MM/DD/YYYY)
7/1/2020
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3. Issuer Name and Ticker or Trading Symbol
ENDOLOGIX INC /DE/ [ELGX]
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(Last)
(First)
(Middle)
2 MUSICK |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director _____ 10% Owner ___X___ Officer (give title below) _____ Other (specify below) Interim CFO / |
(Street)
IRVINE, CA 92618
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 6. Individual or Joint/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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1.Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock | 24549 (1) | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 4) | 2. Date Exercisable and Expiration Date (MM/DD/YYYY) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) |
Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Option to Purchase | 12/30/2019 | 12/30/2028 | Common Stock | 12255.0 (2) | $7.45 | D | |
Option to Purchase | 9/5/2019 | 8/5/2029 | Common Stock | 15867.0 (3) | $6.67 | D | |
Option to Purchase | 9/10/2020 | 9/10/2026 | Common Stock | 1572.0 (4) | $4.71 | D | |
Explanation of Responses: |
(1) | The number of shares beneficially owned includes 24,410 shares subject to time-based restricted stock unit awards and 139 shares purchased through the Company's Employee Stock Purchase Plan. |
(2) | 100% of the option award vested on December 30, 2019. |
(3) | Options vest ratably over thirty-six months. |
(4) | The reporting person received this stock option pursuant to the option exchange program. The options vest in three equal annual installments over a three-year period commencing on September 10, 2019. |
Remarks: EXHIBIT LIST: EX-24 Power of Attorney for Cynthia Buch Pinto |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Pinto Cynthia Buch 2 MUSICK IRVINE, CA 92618 |
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| Interim CFO |
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Signatures
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Cynthia Buch Pinto by Timothy N. Brady Attorney-in-Fact for Reporting Person | | 7/10/2020 |
**Signature of Reporting Person | Date |
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