Form Type: 4

SEC EDGAR Link
Accession Number:0001562180-20-000265
Date:2020-01-03
Issuer: SI-BONE, INC. (SIBN)
Original Submission Date:

Reporting Person:

RECUPERO ANTHONY J
C/O SI-BONE, INC.
471 EL CAMINO REAL, SUITE 101 SANTA CLARA, CA 95050

Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
Title of SecurityTransaction Date2a. Deemed Execution Date Transaction CodeSharesAcquired or DisposedPrice per share 5. Amount of Securities Beneficially Owned Following Reported Transaction 6. Ownership Form Direct or IndirectNature of Indirect Ownership
COMMON STOCK 2020-01-03 A 54,050 a $0.00 72,968 direct
Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, convertible securities
Title of Derivative Security Conversion or Exercise Price of Derivative Security Transaction Date Deemed Execution Date Transaction Code Number of Derivative Securities Acquired (A) or Disposed of (D) Date ExercisableExpiration Date Title and Amount of Securities Underlying Derivative Security Price of Derivative Security Number of derivative Securities Beneficially Owned Following Reported Transaction(s) Ownership Form: Direct (D) or Indirect (I) Nature of Indirect Beneficial Ownership
Footnotes
IDfootnote
f1 reflects 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. the shares subject to the restricted stock unit will be vesting over four years beginning on january 1, 2020 and will be released in quarterly installments commencing on may 15, 2020, subject to the reporting person's continued service through each relevant vesting date.
f2 includes 70,056 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.
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