0001562180-19-003577.txt : 20190617
0001562180-19-003577.hdr.sgml : 20190617
20190617194145
ACCESSION NUMBER: 0001562180-19-003577
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: Foley Mark J
CENTRAL INDEX KEY: 0001529196
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38701
FILM NUMBER: 19902443
MAIL ADDRESS:
STREET 1: ZELTIQ AESTHETICS INC.
STREET 2: 4698 WILLOW ROAD SUITE 100
CITY: PLEASANTON
STATE: CA
ZIP: 94588
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
0001529196
Foley Mark J
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 Mark J. Foley
2019-06-17