0001562180-21-002743.txt : 20210407 0001562180-21-002743.hdr.sgml : 20210407 20210407173758 ACCESSION NUMBER: 0001562180-21-002743 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210405 FILED AS OF DATE: 20210407 DATE AS OF CHANGE: 20210407 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: 21813182 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 2021-04-05 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 2021-04-05 4 S false 37595.00 30.5086 D 71323.00 I by Trust Common Stock 2021-04-05 4 S false 2405.00 31.3308 D 68918.00 I by Trust Common Stock 264125.00 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 $30.08 to $31.04, 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. The price reported in column 4 is a weighted-average price. The shares were sold in multiple transactions ranging from $31.13 to $31.84, 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. Reflects the transfer of shares from the Reporting Person to The Jeffrey W. Dunn Living Trust Dated May 17, 2012. Represents 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 2021-04-07