0001209191-19-025163.txt : 20190417
0001209191-19-025163.hdr.sgml : 20190417
20190417194009
ACCESSION NUMBER: 0001209191-19-025163
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190415
FILED AS OF DATE: 20190417
DATE AS OF CHANGE: 20190417
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: FRANCIS LAURA
CENTRAL INDEX KEY: 0001218802
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38701
FILM NUMBER: 19754160
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
2019-04-15
0
0001459839
SI-BONE, Inc.
SIBN
0001218802
FRANCIS LAURA
C/O SI-BONE, INC.
471 EL CAMINO REAL, SUITE 101
SANTA CLARA
CA
95050
0
1
0
0
Chief Financial Officer
Common Stock
2019-04-15
4
M
0
2518
4.32
A
73536
D
Common Stock
2018-04-15
4
S
0
2518
16.9415
D
71018
D
Common Stock
2018-04-15
4
S
0
494
16.5348
D
70524
D
Stock Option (right to buy)
4.32
2019-04-15
4
M
0
2518
0.00
D
2025-05-25
Common Stock
2518
186700
D
Includes 25,078 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 sale reported on this Form 4 was effected pursuant to a 10b5-1 trading plan.
The price reported in column 4 is a weighted-average price. The shares were sold in multiple transactions ranging from $16.595 to $17.40, inclusive. The Reporting Person undertakes to provide the Issuer, any securityholder of the Issuer, or the Staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth in footnotes 3 and 5.
The sale reported on this Form 4 represents shares required to be sold by the Reporting Person to cover tax withholding obligations in connection with the vesting of restricted stock units. The sale satisfies the tax withholding obligations to be funded by a "sell to cover" transaction and does not represent a discretionary trade by the Reporting Person.
The price reported in column 4 is a weighted-average price. The shares were sold in multiple transactions ranging from $16.37 to $16.59, inclusive.
The shares subject to the option vest in equal monthly installments over four years commencing on May 26, 2015, subject to Reporting Person's continued service through each relevant vesting date. The shares subject to this option may be exercised prior to vesting, subject to Issuer's right to repurchase.
/s/ Michael A. Pisetsky, Attorney-in-Fact for Laura A. Francis
2019-04-17