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