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SIBN SI BONE Inc

15.58
0.26 (1.70%)
16 Jul 2024 - Closed
Delayed by 15 minutes
Share Name Share Symbol Market Type
SI BONE Inc NASDAQ:SIBN NASDAQ Common Stock
  Price Change % Change Share Price Bid Price Offer Price High Price Low Price Open Price Shares Traded Last Trade
  0.26 1.70% 15.58 15.30 17.08 15.75 15.20 15.32 350,751 01:00:00

Statement of Changes in Beneficial Ownership (4)

28/06/2021 10:12pm

Edgar (US Regulatory)


FORM 4 [ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).         
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
                                                                                  
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response...
0.5                       
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
                      

1. Name and Address of Reporting Person *

DUNN JEFFREY W
2. Issuer Name and Ticker or Trading Symbol

SI-BONE, Inc. [ SIBN ]
5. Relationship of Reporting Person(s) to Issuer (Check all applicable)

__X__ Director                    _____ 10% Owner
_____ Officer (give title below)    _____ Other (specify below)
(Last)          (First)          (Middle)

C/O SI-BONE, INC., 471 EL CAMINO REAL, SUITE 101
3. Date of Earliest Transaction (MM/DD/YYYY)

6/24/2021
(Street)

SANTA CLARA, CA 95050
(City)        (State)        (Zip)
4. If Amendment, Date Original Filed (MM/DD/YYYY)

 
6. Individual or Joint/Group Filing (Check Applicable Line)

_X _ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Trans. Date 2A. Deemed Execution Date, if any 3. Trans. Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 6/24/2021  M  13327.00 A$4.32 198091.00 D  
Common Stock 6/24/2021  S(1)  13327.00 D$32.2278 (2)184764.00 (3)D  
Common Stock         56128.00 I by Trust (4)

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivate Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security3. Trans. Date3A. Deemed Execution Date, if any4. Trans. Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
6. Date Exercisable and Expiration Date7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)11. Nature of Indirect Beneficial Ownership (Instr. 4)
CodeV(A)(D)Date ExercisableExpiration DateTitleAmount or Number of Shares
Stock Option (Right to Buy) $4.32 6/24/2021  M     13327.00   (5)5/25/2025 Common Stock 13327.00 $0.00 26340.00 D  

Explanation of Responses:
(1) The sale reported on this Form 4 was effected pursuant to a 10b5-1 trading plan.
(2) The price reported in column 4 is a weighted-average price. The shares were sold in multiple transactions ranging from $32.00 to $32.75, inclusive. The Reporting Person undertakes to provide the Issuer, any securityholder 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 footnotes.
(3) Represents shares issuable on the settlement of the net restricted stock units granted and canceled to the Reporting Person. Each restricted stock unit represents a contingent right to receive one share of the Issuer's common stock.
(4) Shares held by The Jeffrey W. Dunn Living Trust Dated May 17, 2012.
(5) The shares subject to the option vest in equal monthly installments over four years commencing on vesting commencement date, subject to Reporting Person's continued service through each relevant vesting date.

Reporting Owners
Reporting Owner Name / Address
Relationships
Director10% OwnerOfficerOther
DUNN JEFFREY W
C/O SI-BONE, INC.
471 EL CAMINO REAL, SUITE 101
SANTA CLARA, CA 95050
X



Signatures
/s/ Michael A. Pisetsky, Attorney-in-Fact for Jeffrey W. Dunn6/28/2021
**Signature of Reporting PersonDate

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