0001562180-21-002886.txt : 20210420
0001562180-21-002886.hdr.sgml : 20210420
20210420162433
ACCESSION NUMBER: 0001562180-21-002886
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210418
FILED AS OF DATE: 20210420
DATE AS OF CHANGE: 20210420
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: 21838135
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
primarydocument.xml
PRIMARY DOCUMENT
X0306
4
2021-04-18
false
0001459839
SI-BONE, Inc.
SIBN
0001218802
FRANCIS LAURA
C/O SI-BONE, INC.
471 EL CAMINO REAL, SUITE 101
SANTA CLARA
CA
95050
true
true
false
false
Chief Financial Officer
Common Stock
2021-04-18
4
A
false
32864.00
0.00
A
211977.00
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 be vesting over four years
and will be released in quarterly installments commencing on May 15, 2021, subject to the Reporting Person's continued service through each
relevant vesting date.
Includes 149,792 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 Laura A. Francis
2021-04-20