0001562180-19-003442.txt : 20190610 0001562180-19-003442.hdr.sgml : 20190610 20190610165142 ACCESSION NUMBER: 0001562180-19-003442 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190606 FILED AS OF DATE: 20190610 DATE AS OF CHANGE: 20190610 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Yerby Scott A CENTRAL INDEX KEY: 0001754756 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38701 FILM NUMBER: 19889058 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 primarydocument.xml PRIMARY DOCUMENT X0306 4 2019-06-06 false 0001459839 SI-BONE, Inc. SIBN 0001754756 Yerby Scott A C/O SI-BONE, INC. 471 EL CAMINO REAL, SUITE 101 SANTA CLARA CA 95050 false true false false Chief Technology Officer Common Stock 2019-06-06 4 S false 648.00 17.19 D 8960.00 D Common Stock 185187.00 I By Trust The sale reported on this Form 4 was effected pursuant to a 10b5-1 trading plan. Includes 9,562 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. Shares held by The Yerby Family Trust Dated May 22, 2007 /s/ Michael A. Pisetsky, Attorney-in-Fact for Scott A. Yerby 2019-06-10