0001209191-19-025164.txt : 20190417 0001209191-19-025164.hdr.sgml : 20190417 20190417194152 ACCESSION NUMBER: 0001209191-19-025164 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: Pisetsky Michael A CENTRAL INDEX KEY: 0001754765 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38701 FILM NUMBER: 19754164 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 0001754765 Pisetsky Michael A C/O SI-BONE, INC. 471 EL CAMINO REAL, SUITE 101 SANTA CLARA CA 95050 0 1 0 0 GC & Chief Compliance Officer Common Stock 2019-04-15 4 S 0 241 16.59 D 18073 D 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. Includes 10,687 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. /s/ Michael A. Pisetsky 2019-04-17