0001562180-19-004500.txt : 20190827
0001562180-19-004500.hdr.sgml : 20190827
20190827151332
ACCESSION NUMBER: 0001562180-19-004500
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190826
FILED AS OF DATE: 20190827
DATE AS OF CHANGE: 20190827
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Freund John Gordon
CENTRAL INDEX KEY: 0001296771
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38701
FILM NUMBER: 191057055
MAIL ADDRESS:
STREET 1: 125 UNIVERSITY AVE.
STREET 2: C/O SKYLINE VENTURES
CITY: PALO ALTO
STATE: CA
ZIP: 94301
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
2019-08-26
false
0001459839
SI-BONE, Inc.
SIBN
0001296771
Freund John Gordon
C/O SKYLINE VENTURES
525 UNIVERSITY AVENUE, SUITE 1350
PALO ALTO
CA
94301
true
false
true
false
Common Stock
2019-08-26
4
S
false
152424.00
18.4038
D
3819985.00
I
By Skyline Venture Partner V, L.P.
The price reported in column 4 is a weighted-average price. The shares were sold in multiple transactions ranging from $18.40 to $19.21, 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 range set forth in this footnote.
Shares held by Skyline Venture Partners V, L.P. ("SVP V"). Skyline Venture Management V, LLC ("LLC") is the general partner of SVP V and as such may be deemed to have voting and investment power with respect to the securities of SVP V. Dr. Freund, a member of the Issuer's board of directors, together with Yasunori Kaneko, are the managing directors of LLC and each may be deemed to have voting and investment power with respect to the securities held by SVP V. Dr. Freund and Mr. Kaneko disclaim beneficial ownership of such securities, except to the extent of their pecuniary interest therein.
/s/ Michael A. Pisetsky, Attorney-in-Fact for John G. Freund
2019-08-27