0001562180-19-003567.txt : 20190617
0001562180-19-003567.hdr.sgml : 20190617
20190617183701
ACCESSION NUMBER: 0001562180-19-003567
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190613
FILED AS OF DATE: 20190617
DATE AS OF CHANGE: 20190617
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: HINCKLEY GREGORY K
CENTRAL INDEX KEY: 0001239182
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38701
FILM NUMBER: 19902312
MAIL ADDRESS:
STREET 1: C/OMENTOR GRAPHICS CORP
STREET 2: 8005 SW BOECKMAN ROAD
CITY: WILSONVILLE
STATE: OR
ZIP: 97070-7777
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
2019-06-13
false
0001459839
SI-BONE, Inc.
SIBN
0001239182
HINCKLEY GREGORY K
C/O SI-BONE, INC.
471 EL CAMINO REAL, SUITE 101
SANTA CLARA
CA
95050
true
false
false
false
Stock Options (Right to buy)
17.72
2019-06-13
4
A
false
15741.00
0.00
A
2029-06-12
Common Stock
15741.00
15741.00
D
The shares subject to the option will vest in a series of 12 equal monthly increments over the one-year period following the Vesting Commencement Date, such that the option will be fully vested on the first anniversary of the Vesting Commencement Date, subject to the Reporting Person's continuous service as a member of the Issuer's Board of Directors on each such applicable vesting date.
/s/ Michael A. Pisetsky, Attorney-in-Fact for Gregory K. Hinckley
2019-06-17