0001562180-21-001288.txt : 20210218
0001562180-21-001288.hdr.sgml : 20210218
20210218190744
ACCESSION NUMBER: 0001562180-21-001288
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210216
FILED AS OF DATE: 20210218
DATE AS OF CHANGE: 20210218
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Pisetsky Michael A
CENTRAL INDEX KEY: 0001754765
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38701
FILM NUMBER: 21651348
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
2021-02-16
false
0001459839
SI-BONE, Inc.
SIBN
0001754765
Pisetsky Michael A
C/O SI-BONE, INC.
471 EL CAMINO REAL, SUITE 101
SANTA CLARA
CA
95050
false
true
false
false
GC & Chief Compliance Officer
Common Stock
2021-02-16
4
S
false
684.00
31.0522
D
75459.00
D
Common Stock
2021-02-16
4
M
false
2125.00
4.32
A
77584.00
D
Common Stock
2021-02-16
4
S
false
2125.00
30.9509
D
75459.00
D
Stock Option (Right to Buy)
4.32
2021-02-16
4
M
false
2125.00
0.00
D
2026-07-26
Common Stock
2125.00
14913.00
D
The sale reported on this Form 4 represents shares required to be sold by the Reporting Person to cover tax withholding obligations in connection with the vesting of restricted stock units. The sale satisfies the tax withholding obligations to be funded by a "sell to cover" transaction and does not represent a discretionary trade by the Reporting Person.
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 $30.77 to $31.23, 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.
Includes 57,759 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.
The shares subject to the option vest in equal monthly installments over four years commencing on vesting commencement date, subject to Reporting Person's continued service through each relevant vesting date.
/s/ Michael A. Pisetsky
2021-02-18