Form Type: 4

SEC EDGAR Link
Accession Number:0001562180-22-004167
Date:2022-05-16
Issuer: SI-BONE, INC. (SIBN)
Original Submission Date:

Reporting Person:

PISETSKY MICHAEL A
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 2022-05-16 S 878 d $12.58 125,178 direct
COMMON STOCK 2022-05-16 S 1,419 d $12.58 123,759 direct
COMMON STOCK 2022-05-16 S 128 d $12.58 123,631 direct
COMMON STOCK 2022-05-16 S 50 d $12.58 123,581 direct
COMMON STOCK 2022-05-16 S 991 d $12.58 123,724 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 the sale reported on this form 4 represents shares required to be sold by the reporting person to cover tax withholding obligations in connection with the vesting of restricted stock units. the sale satisfies the tax withholding obligations to be funded by a "sell to cover" transactionand does not represent a discretionary trade by the reporting person.
f2 includes 81,706 shares issuable on settlement of restricted stock units granted to the reporting person. each restricted stock unit representsa contingent right to receive one share of the issuer's common stock.
f3 includes 1,134 shares acquired under the si-bone, inc. 2018 employee stock purchase plan on may 15, 2022.

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