0001562180-19-004000.txt : 20190719
0001562180-19-004000.hdr.sgml : 20190719
20190719140427
ACCESSION NUMBER: 0001562180-19-004000
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190718
FILED AS OF DATE: 20190719
DATE AS OF CHANGE: 20190719
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: 19963062
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
2019-07-18
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
2019-07-18
4
S
false
1436.00
20.1586
D
99997.00
D
Common Stock
547540.00
I
by Trust
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 92,920 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.
Shares held by The Jeffrey W. Dunn Living Trust Dated May 17, 2012.
/s/ Michael A. Pisetsky, Attorney-in-Fact for Jeffrey W. Dunn
2019-07-19