SEC FORM
3
SEC Form 3
| 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
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| OMB APPROVAL |
| OMB Number: |
3235-0104 |
| Estimated average burden |
| hours per response: |
0.5 |
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1. Name and Address of Reporting Person*
| 1331 TYLER STREET NE, SUITE 200 |
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(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year)
09/20/2017
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3. Issuer Name and Ticker or Trading Symbol
TACTILE SYSTEMS TECHNOLOGY INC
[ TCMD ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
| X |
Director |
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10% Owner |
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Officer (give title below) |
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Other (specify below) |
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5. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
| X |
Form filed by One Reporting Person |
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Form filed by More than One Reporting Person |
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| Table I - Non-Derivative Securities Beneficially Owned |
|---|
| 1. Title of Security (Instr.
4)
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2.
Amount of Securities Beneficially Owned (Instr.
4)
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3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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4. Nature of Indirect Beneficial Ownership (Instr.
5)
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Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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|---|
| 1. Title of Derivative Security (Instr.
4)
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2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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6. Nature of Indirect Beneficial Ownership (Instr.
5)
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| Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
| Explanation of Responses: |
| Remarks: |
|
| No securities are beneficially owned. |
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/s/ Christine G. Long, Attorney-in-Fact |
09/22/2017 |
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** Signature of Reporting Person |
Date |
| 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,
see
Instruction
5
(b)(v). |
| ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations
See
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,
see
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. |
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, Anne
Kruger, John A. Haveman, 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 rules thereunder;
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 9th day of September, 2017.
/s/ Raymond Huggenberger
