0001209191-19-025163.txt : 20190417 0001209191-19-025163.hdr.sgml : 20190417 20190417194009 ACCESSION NUMBER: 0001209191-19-025163 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190415 FILED AS OF DATE: 20190417 DATE AS OF CHANGE: 20190417 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: 19754160 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 doc4.xml FORM 4 SUBMISSION X0306 4 2019-04-15 0 0001459839 SI-BONE, Inc. SIBN 0001218802 FRANCIS LAURA C/O SI-BONE, INC. 471 EL CAMINO REAL, SUITE 101 SANTA CLARA CA 95050 0 1 0 0 Chief Financial Officer Common Stock 2019-04-15 4 M 0 2518 4.32 A 73536 D Common Stock 2018-04-15 4 S 0 2518 16.9415 D 71018 D Common Stock 2018-04-15 4 S 0 494 16.5348 D 70524 D Stock Option (right to buy) 4.32 2019-04-15 4 M 0 2518 0.00 D 2025-05-25 Common Stock 2518 186700 D Includes 25,078 shares issuable on settlement of restricted stock units granted to the Reporting Person. Each restricted stock unit represents a contingent right to receive one shares of the Issuer's common stock. The sale reported on this Form 4 was effected pursuant to a 10b5-1 trading plan. The price reported in column 4 is a weighted-average price. The shares were sold in multiple transactions ranging from $16.595 to $17.40, 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 ranges set forth in footnotes 3 and 5. The sale reported on this Form 4 represents shares required to be sold by the Reporting Person to cover tax withholding obligations in connection with the vesting of restricted stock units. The sale satisfies the tax withholding obligations to be funded by a "sell to cover" transaction and does not represent a discretionary trade by the Reporting Person. The price reported in column 4 is a weighted-average price. The shares were sold in multiple transactions ranging from $16.37 to $16.59, inclusive. The shares subject to the option vest in equal monthly installments over four years commencing on May 26, 2015, subject to Reporting Person's continued service through each relevant vesting date. The shares subject to this option may be exercised prior to vesting, subject to Issuer's right to repurchase. /s/ Michael A. Pisetsky, Attorney-in-Fact for Laura A. Francis 2019-04-17