Sec Form 4 Filing - RECUPERO ANTHONY J @ SI-BONE, Inc. - 2019-04-15

Insider filing report for Changes in Beneficial Ownership
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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
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
RECUPERO ANTHONY J
2. Issuer Name and Ticker or Trading Symbol
SI-BONE, Inc. [ SIBN]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
Chief Commercial Officer
(Last) (First) (Middle)
C/O SI-BONE, INC., 471 EL CAMINO REAL, SUITE 101
3. Date of Earliest Transaction (MM/DD/YY)
04/15/2019
(Street)
SANTA CLARA, CA95050
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction 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 04/15/2019 M 1,000 A $ 4.32 20,700 ( 1 ) D
Common Stock 04/15/2019 S( 2 ) 1,000 D $ 17.0237 ( 3 ) 19,700 ( 1 ) D
Common Stock 04/15/2019 S( 4 ) 427 D $ 16.5455 ( 5 ) 19,273 ( 1 ) D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4, and 5)
6. Date Exercisable and Expiration Date
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(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)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (right to buy) $ 4.32 04/15/2019 M 1,000 ( 6 ) 07/26/2026 Common Stock 1,000 $ 0 124,590 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
RECUPERO ANTHONY J
C/O SI-BONE, INC.
471 EL CAMINO REAL, SUITE 101
SANTA CLARA, CA95050
Chief Commercial Officer
Signatures
/s/ Michael A. Pisetsky, Attorney-in-Fact for Anthony J. Recupero 04/17/2019
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Includes 18,469 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.
( 2 )The sale reported on this Form 4 was effected pursuant to a 10b5-1 trading plan.
( 3 )The price reported in column 4 is a weighted-average price. The shares were sold in multiple transactions ranging from $16.69 to $17.45, 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 footnotes 3 and 5.
( 4 )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" transaction and does not represent a discretionary trade by the Reporting Person.
( 5 )The price reported in column 4 is a weighted-average price. The shares were sold in multiple transactions ranging from $16.40 to $16.59, inclusive.
( 6 )The shares subject to the option vest as to 25% on the 12-month anniversary of July 5, 2016, and 1/36th of the balance of the shares vest each month thereafter, subject to Reporting Person's continued service through each relevant vesting date.

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).

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