0001562180-23-000312.txt : 20230109 0001562180-23-000312.hdr.sgml : 20230109 20230109184947 ACCESSION NUMBER: 0001562180-23-000312 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230106 FILED AS OF DATE: 20230109 DATE AS OF CHANGE: 20230109 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: RECUPERO ANTHONY J CENTRAL INDEX KEY: 0001210230 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38701 FILM NUMBER: 23519322 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 2023-01-06 false 0001459839 SI-BONE, Inc. SIBN 0001210230 RECUPERO ANTHONY J C/O SI-BONE, INC. 471 EL CAMINO REAL, SUITE 101 SANTA CLARA CA 95050 false true false false President, Commercial Ops Common Stock 2023-01-06 4 A false 57478.00 0.00 A 220690.00 D Common Stock 2023-01-06 4 A false 19159.00 0.00 A 239849.00 D Reflects 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 restricted stock unit will vest over four years beginning on January 1, 2023, and will be released in quarterly installments, subject to the Reporting Person's continued service through each relevant vesting date. Reflects 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 restricted stock unit will vest, if at all, over three years based on the Issuer's total shareholder return (TSR) as measured against the TSR of the company at the median of the range TSRs of a set of peer companies established by the Issuer as set forth in the grant. Includes 183,916 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 Anthony J. Recupero 2023-01-09