0001562180-19-003911.txt : 20190710 0001562180-19-003911.hdr.sgml : 20190710 20190710141803 ACCESSION NUMBER: 0001562180-19-003911 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190708 FILED AS OF DATE: 20190710 DATE AS OF CHANGE: 20190710 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: 19948951 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 2019-07-08 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 2019-07-08 4 S false 648.00 19.01 D 143006.00 I By Trust Common Stock 9984.00 D The sale reported on this Form 4 was effected pursuant to a 10b5-1 trading plan. Shares held by The Yerby Family Trust Dated May 22, 2007 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. /s/ Michael A. Pisetsky, Attorney-in-Fact for Scott A. Yerby 2019-07-10