Form Type: 4

SEC EDGAR Link
Accession Number:0001562180-20-004585
Date:2020-06-16
Issuer: SI-BONE, INC. (SIBN)
Original Submission Date:

Reporting Person:

HINCKLEY GREGORY K
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 2020-06-16 A 8,797 a $0.00 49,588 direct
COMMON STOCK 2020-06-16 0 $0.00 75,603 f3 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 the settlement of restricted stock units granted to the reporting person. each restricted stock unit represents acontingent right to receive one share of the issuer's common stock. the shares subject to the restricted stock unit will be vesting 100% upon the earlier of (i) the next annual general meeting of the stockholders of the company or (ii) the date one year from the vesting commencement date, subject to the reporting person's continuous service as a member of the company's board of directors until such date.
f2 includes 8,797 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.
f3 shares held by gregory k. hinckley and mary c. hinckley as community property with the right of survivorship.
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