0001562180-24-005137.txt : 20240617
0001562180-24-005137.hdr.sgml : 20240617
20240617202046
ACCESSION NUMBER: 0001562180-24-005137
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240614
FILED AS OF DATE: 20240617
DATE AS OF CHANGE: 20240617
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: FRANCIS LAURA
CENTRAL INDEX KEY: 0001218802
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38701
FILM NUMBER: 241049900
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]
ORGANIZATION NAME: 08 Industrial Applications and Services
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
2024-06-14
false
0001459839
SI-BONE, Inc.
SIBN
0001218802
FRANCIS LAURA
C/O SI-BONE, INC.
471 EL CAMINO REAL, SUITE 101
SANTA CLARA
CA
95050
true
true
false
false
Chief Executive Officer
false
Common Stock
2024-06-14
4
M
false
11277.00
4.68
A
512753.00
D
Common Stock
2024-06-14
4
M
false
57392.00
4.32
A
502890.00
D
Common Stock
166951.00
I
by Trust
Stock Option (Right to Buy)
4.68
2024-06-14
4
M
false
11277.00
0.00
D
2027-03-01
Common Stock
11277.00
0.00
D
Stock Option (Right to Buy)
4.32
2024-06-14
4
M
false
57392.00
0.00
D
2025-05-25
Common Stock
57392.00
0.00
D
Reflects the transfer of shares from the Reporting Person to The David & Laura Francis Joint Rev Tr.
Includes 1,414 shares acquired under the SI-BONE, Inc. 2018 Employee Stock Purchase Plan on May 15, 2024.
Includes 335,545 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.
Shares held by The David & Laura Francis Joint Rev Tr.
The shares subject to the option vest in equal monthly installments over four years commencing on December 12, 2017, subject to Reporting
Person's continued service through each relevant vesting date. The shares subject to this option may be exercised prior to vesting, subject to
Issuer's right to repurchase.
The shares subject to the option vest in equal monthly installments over four years commencing on May 26, 2015, subject to Reporting
Person's continued service through each relevant vesting date. The shares subject to this option may be exercised prior to vesting, subject to
Issuer's right to repurchase.
/s/ Michael A. Pisetsky, Attorney-in-Fact for Laura A. Francis
2024-06-17