SEC Form 3
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
|Estimated average burden|
|hours per response:
1. Name and Address of Reporting Person*
|1331 TYLER STREET NE, SUITE 200|
2. Date of Event Requiring Statement
3. Issuer Name and Ticker or Trading Symbol
TACTILE SYSTEMS TECHNOLOGY INC
[ TCMD ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
||Officer (give title below)
||Other (specify below)
|Chief Financial Officer||
5. If Amendment, Date of Original Filed
6. Individual or Joint/Group Filing (Check Applicable Line)
||Form filed by One Reporting Person
||Form filed by More than One Reporting Person
|Table I - Non-Derivative Securities Beneficially Owned|
|1. Title of Security (Instr.
Amount of Securities Beneficially Owned (Instr.
||3. Ownership Form: Direct (D) or Indirect (I) (Instr.
||4. Nature of Indirect Beneficial Ownership (Instr.
Table II - Derivative Securities Beneficially Owned|
(e.g., puts, calls, warrants, options, convertible securities)
|1. Title of Derivative Security (Instr.
||2. Date Exercisable and Expiration Date
||3. Title and Amount of Securities Underlying Derivative Security (Instr.
||4. Conversion or Exercise Price of Derivative Security
||5. Ownership Form: Direct (D) or Indirect (I) (Instr.
||6. Nature of Indirect Beneficial Ownership (Instr.
||Amount or Number of Shares
|Explanation of Responses:|
|No securities are beneficially owned.|
||/s/ Jonathan R. Zimmerman, Attorney-in-Fact
||** Signature of Reporting Person
|Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.|
|* If the form is filed by more than one reporting person,
|** Intentional misstatements or omissions of facts constitute Federal Criminal Violations
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).|
|Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
Instruction 6 for procedure.|
|Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.|
EX-24: POWER OF ATTORNEY
For Executing Forms 144, Forms 3, 4, 5 and Form ID
The undersigned hereby constitutes and appoints Gerald Mattys,
Lynn Blake, Robert Folkes, Jonathan R. Zimmerman, Christine G. Long,
Jonny Nemani, Tonya LaBrec and Amra Hoso, and each of them, the
undersigned's true and lawful attorney-in-fact, for such period
of time that the undersigned is required to file reports pursuant
to Section 16(a) of the Securities Exchange Act of 1934, as
amended (the "Exchange Act"), or Rule 144 of the Securities Act of 1933,
as amended (the "Securities Act"), due to the undersigned's affiliation
with Tactile Systems Technology, Inc., a Delaware corporation,
unless earlier revoked by the undersigned in a signed writing
delivered to the foregoing attorneys-in-fact, to:
1) execute for and on behalf of the undersigned Forms 144, Forms 3, 4, 5
and Form ID and any amendments to previously filed forms in accordance with
Section 16(a) of the Exchange Act or Rule 144 of the Securities Act and the
2) do and perform any and all acts for and on behalf of the undersigned
which may be necessary or desirable to complete the execution of any such
Forms 144, Forms 3, 4, 5 and Form ID and the timely filing of such form with
the United States Securities and Exchange Commission and any other authority
as required by law; and
3) take any other action of any type whatsoever in connection with the
foregoing which, in the opinion of such attorney-in-fact, may be of benefit
to, in the best interest of or legally required by the undersigned, it being
understood that the documents executed by such attorney-in-fact on behalf of
the undersigned pursuant to this Power of Attorney shall be in such form and
shall contain such terms and conditions as such attorney-in-fact may approve
in his discretion.
The undersigned hereby grants to each such attorney-in-fact full power and
authority to do and perform all and every act and thing whatsoever requisite,
necessary and proper to be done in the exercise of any of the rights and powers
herein granted, as fully to all intents and purposes as the undersigned could do
if personally present, with full power of substitution or revocation, hereby
ratifying and confirming all that such attorney-in-fact, or his or her
substitute or substitutes, shall lawfully do or cause to be done by
virtue of this Power of Attorney and the rights and powers herein granted.
The undersigned acknowledges that the foregoing attorneys-in-fact,
in serving in such capacity at the request of the undersigned,
are not assuming any of the undersigned's responsibilities to
comply with Section 16 of the Exchange Act or Rule 144 of the Securities Act.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of this September 2, 2018.
/s/ Brent A. Moen