0001562180-23-001494.txt : 20230217 0001562180-23-001494.hdr.sgml : 20230217 20230217160831 ACCESSION NUMBER: 0001562180-23-001494 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230216 FILED AS OF DATE: 20230217 DATE AS OF CHANGE: 20230217 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: 23642539 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 2023-02-16 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 SVP, Ops & Adm/Chief Legal Ofr Common Stock 2023-02-16 4 S false 866.00 16.7836 D 171242.00 D Common Stock 2023-02-16 4 S false 1399.00 16.7611 D 169843.00 D Common Stock 2023-02-16 4 S false 124.00 16.8488 D 169719.00 D Common Stock 2023-02-16 4 S false 977.00 16.7068 D 168742.00 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. Includes 115,062 shares issuable on settlement of restricted stock units granted to the Reporting Person. Each restricted stock unit represents a contingent right to receive one shares of the Issuer's common stock. /s/ Michael A. Pisetsky 2023-02-17