0001209191-19-004390.txt : 20190117
0001209191-19-004390.hdr.sgml : 20190117
20190117184417
ACCESSION NUMBER: 0001209191-19-004390
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190115
FILED AS OF DATE: 20190117
DATE AS OF CHANGE: 20190117
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: RECUPERO ANTHONY J
CENTRAL INDEX KEY: 0001210230
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38701
FILM NUMBER: 19531809
MAIL ADDRESS:
STREET 1: C/O SI-BONE, INC.
STREET 2: 471 EL CAMINO REAL, SUITE 101
CITY: SANTA CLARA
STATE: CA
ZIP: 95050
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: SI-BONE, Inc.
CENTRAL INDEX KEY: 0001459839
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 262216351
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 471 EL CAMINO REAL, SUITE 101
CITY: SANTA CLARA
STATE: CA
ZIP: 95050
BUSINESS PHONE: 4082070700
MAIL ADDRESS:
STREET 1: 471 EL CAMINO REAL, SUITE 101
CITY: SANTA CLARA
STATE: CA
ZIP: 95050
FORMER COMPANY:
FORMER CONFORMED NAME: SI-Bone Inc.
DATE OF NAME CHANGE: 20090326
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2019-01-15
0
0001459839
SI-BONE, Inc.
SIBN
0001210230
RECUPERO ANTHONY J
C/O SI-BONE, INC.
471 EL CAMINO REAL, SUITE 101
SANTA CLARA
CA
95050
0
1
0
0
Chief Commercial Officer
Common Stock
2019-01-15
4
A
0
19700
0.00
A
19700
D
Stock Option (right to buy)
22.00
2019-01-15
4
A
0
42700
0.00
A
2029-01-15
Common Stock
42700
42700
D
Reflects shares issuable on settlement of restricted stock units granted to the Reporting Person. Each restricted stock unit represents a contingent right to receive one shares of the Issuer's common stock. The shares subject to the restricted stock unit vest in equal quarterly installments over four years commencing on January 15, 2019, subject to the Reporting Person's continued service through each relevant vesting date.
The shares subject to the option vest in equal monthly installments over four years commencing on January 15, 2019, subject to Reporting Person's continued service through each relevant vesting date.
/s/ Michael A. Pisetsky, Attorney-in-Fact for Anthony J. Recupero
2019-01-17