0001562180-24-000312.txt : 20240105
0001562180-24-000312.hdr.sgml : 20240105
20240105175314
ACCESSION NUMBER: 0001562180-24-000312
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240105
FILED AS OF DATE: 20240105
DATE AS OF CHANGE: 20240105
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: RECUPERO ANTHONY J
CENTRAL INDEX KEY: 0001210230
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38701
FILM NUMBER: 24517718
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]
ORGANIZATION NAME: 08 Industrial Applications and Services
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
primarydocument.xml
PRIMARY DOCUMENT
X0508
4
2024-01-05
false
0001459839
SI-BONE, Inc.
SIBN
0001210230
RECUPERO ANTHONY J
C/O SI-BONE, INC.
471 EL CAMINO REAL, SUITE 101
SANTA CLARA
CA
95050
false
true
false
false
President, Commercial Ops
false
Common Stock
2024-01-05
4
A
false
51007.00
0.00
A
249910.00
D
Common Stock
2024-01-05
4
A
false
17002.00
0.00
A
266912.00
D
Reflects shares issuable on the settlement of restricted stock units granted to the Reporting Person. Each restricted stock unit represents a contingent right to receive one share of the Issuer's common stock. The shares subject to the restricted stock unit will vest over four years
beginning on January 1, 2024, and will be released in quarterly installments, subject to the Reporting Person's continued service through each relevant vesting date.
Reflects shares issuable on the settlement of restricted stock units granted to the Reporting Person. Each restricted stock unit represents a contingent right to receive one share of the Issuer's common stock. The shares subject to the restricted stock unit will vest, if at all, over three years based on the Issuer's total shareholder return (TSR) as measured against the TSR of the company at the median of the range TSRs of a set of peer companies established by the Issuer as set forth in the grant.
Includes 190,406 shares issuable on the settlement of restricted stock units granted to the Reporting Person. Each restricted stock unit
represents a contingent right to receive one share of the Issuer's common stock.
/s/ Michael A. Pisetsky, Attorney-in-Fact for Anthony J. Recupero
2024-01-05