0001562180-23-000313.txt : 20230109
0001562180-23-000313.hdr.sgml : 20230109
20230109185039
ACCESSION NUMBER: 0001562180-23-000313
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230106
FILED AS OF DATE: 20230109
DATE AS OF CHANGE: 20230109
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: 23519324
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
2023-01-06
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 Executive Officer
Common Stock
2023-01-06
4
A
false
70252.00
0.00
A
396399.00
D
Common Stock
2023-01-06
4
A
false
70252.00
0.00
A
466651.00
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 April 1, 2023, 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 324,894 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
2023-01-09