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