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