0001562180-19-003576.txt : 20190617 0001562180-19-003576.hdr.sgml : 20190617 20190617194124 ACCESSION NUMBER: 0001562180-19-003576 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190613 FILED AS OF DATE: 20190617 DATE AS OF CHANGE: 20190617 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Donigan Heyward R CENTRAL INDEX KEY: 0001602546 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38701 FILM NUMBER: 19902442 MAIL ADDRESS: STREET 1: 452 DISCOVERY ROAD CITY: VIRGINIA BEACH STATE: VA ZIP: 23451 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 2019-06-13 false 0001459839 SI-BONE, Inc. SIBN 0001602546 Donigan Heyward R C/O SI-BONE, INC. 471 EL CAMINO REAL, SUITE 101 SANTA CLARA CA 95050 true false false false Stock Options (Right to buy) 17.72 2019-06-13 4 A false 26236.00 0.00 A 2029-06-12 Common Stock 26236.00 26236.00 D The shares subject to the option will vest in a series of 36 equal monthly increments over three years starting on the Vesting Commencement Date, such that the shares subject to the option will be fully vested on the third anniversary of the Vesting Commencement Date, subject to the Reporting Person's continuous service as a member of the Issuer's Board of Directors on each applicable vesting date. /s/ Michael A. Pisetsky, Attorney-in-Fact for Heyward R. Donigan 2019-06-17