0001562180-23-007214.txt : 20231004 0001562180-23-007214.hdr.sgml : 20231004 20231004175319 ACCESSION NUMBER: 0001562180-23-007214 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231002 FILED AS OF DATE: 20231004 DATE AS OF CHANGE: 20231004 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: 231309133 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 X0508 4 2023-10-02 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 false false false true Common Stock 2023-10-02 4 M false 20000.00 4.32 A 89645.00 D Common Stock 2023-10-02 4 S false 20000.00 21.1869 D 69645.00 D Common Stock 132580.00 I by Trust Stock Option (Right to Buy) 4.32 2023-10-02 4 M false 20000.00 0.00 D 2026-07-26 Common Stock 20000.00 81241.00 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 $20.96 to $21.51, inclusive. The Reporting Person undertakes to provide the Issuer, any security holder 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 this footnote. Includes 53,089 shares issuable on the settlement of restricted stock units granted to the Reporting Person. Each restricted stock unit represents contingent right to receive one share of the Issuer's common stock. Shares held by The Jeffrey W. Dunn Living Trust Dated May 17, 2012. The shares subject to the option vest in equal monthly installments over four years commencing on the vesting commencement date, subject to Reporting Person's continued service through each relevant vesting date. /s/ Michael A. Pisetsky, Attorney-in-Fact for Jeffrey W. Dunn 2023-10-04