0001562180-21-002250.txt : 20210315 0001562180-21-002250.hdr.sgml : 20210315 20210315183507 ACCESSION NUMBER: 0001562180-21-002250 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210311 FILED AS OF DATE: 20210315 DATE AS OF CHANGE: 20210315 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: 21742957 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 2021-03-11 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 false false Common Stock 2021-03-11 4 S false 63928.00 31.0465 D 1418118.00 I By Skyline Venture Partners V, LP Common Stock 2021-03-12 4 S false 91072.00 31.3912 D 1327046.00 I By Skyline Venture Partners V, LP Common Stock 2021-03-15 4 S false 80887.00 30.9022 D 1246159.00 I By Skyline Venture Partners V, LP Common Stock 100570.00 I By John Freund Family Partnership IV, L.P Shares held by 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. Reporting Person, a member of Issuer's board of directors, is a managing director of LLC and may be deemed to have voting and investment power with respect to the securities held by SVP V. Reporting Person disclaims beneficial ownership of such securities, except to the extent of his pecuniary interest therein. Shares held by John Freund Family Partnership IV, L.P. ("Family LP"). Reporting Person, a member of Issuer's board of directors, is a general partner of Family LP and may be deemed to have voting and investment power with respect to the securities held by Family LP. Reporting Person disclaims beneficial ownership of such securities, except to the extent of his pecuniary interest therein. /s/ Michael A. Pisetsky, Attorney-in-Fact for John G. Freund 2021-03-15