0001562180-21-001010.txt : 20210209
0001562180-21-001010.hdr.sgml : 20210209
20210209173518
ACCESSION NUMBER: 0001562180-21-001010
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210205
FILED AS OF DATE: 20210209
DATE AS OF CHANGE: 20210209
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: DUNN JEFFREY W
CENTRAL INDEX KEY: 0001035986
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38701
FILM NUMBER: 21608077
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
2021-02-05
false
0001459839
SI-BONE, Inc.
SIBN
0001035986
DUNN JEFFREY W
C/O SI-BONE, INC.
471 EL CAMINO REAL, SUITE 101
SANTA CLARA
CA
95050
true
true
false
false
Chairman, President & CEO
Common Stock
2021-02-05
4
S
false
39381.00
32.5259
D
76559.00
I
by Trust
Common Stock
2021-02-05
4
S
false
619.00
33.1096
D
75940.00
I
by Trust
Common Stock
340610.00
D
The sale reported on this Form 4 was effected pursuant to a 10b5-1 trading plan.
The price reported in column 4 is a weighted-average price. The shares were sold in multiple transactions ranging from $31.97 to $32.94, inclusive. The Reporting Person undertakes to provide the Issuer, any securityholder of the Issuer, or the Staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in these footnotes.
The price reported in column 4 is a weighted-average price. The shares were sold in multiple transactions ranging from $33.04 to $33.19, inclusive. The Reporting Person undertakes to provide the Issuer, any securityholder of the Issuer, or the Staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in these footnotes.
Shares held by The Jeffrey W. Dunn Living Trust Dated May 17, 2012.
Includes 273,175 shares issuable on the settlement of restricted stock units granted to the Reporting Person. Each restricted stock unit represents a contingent right to receive one share of the Issuer's common stock.
/s/ Michael A. Pisetsky, Attorney-in-Fact for Jeffrey W. Dunn
2021-02-09