SI-BONE, Inc. — Director's Dealing 2018

Oct 19, 2018

SEC Form 4 — Statement of Changes in Beneficial Ownership

Issuer: SI-BONE, Inc. (SIBN)
CIK: 0001459839
Period of Report: 2018-10-19

Reporting Person: Freund John Gordon (Director, 10% Owner)

Non-Derivative Transactions

Date	Security	Code	Shares	Price	A/D	Holdings After	Ownership
2018-10-19	Common Stock	C	2213425	—	Acquired	2213425	Indirect
2018-10-19	Common Stock	C	792195	—	Acquired	3005620	Indirect
2018-10-19	Common Stock	C	690689	—	Acquired	3696309	Indirect
2018-10-19	Common Stock	C	398676	—	Acquired	4094985	Indirect
2018-10-19	Common Stock	P	325000	$15.00	Acquired	4419985	Indirect

Derivative Transactions

Date	Security	Exercise Price	Code	Shares	A/D	Expiration	Underlying	Ownership
2018-10-19	Warrant (right to buy)	$9.10	X	39421	Disposed		Series 5 Preferred Stock (39421)	Indirect
2018-10-19	Series 5 Preferred Stock	$9.10	X	39421	Acquired		Common Stock (39421)	Indirect
2018-10-19	Series 5 Preferred Stock	$	S	23904	Disposed		Common Stock (23904)	Indirect
2018-10-19	Series 4 Preferred Stock	$	C	2213425	Disposed		Common Stock (2213425)	Indirect
2018-10-19	Series 5 Preferred Stock	$	C	792195	Disposed		Common Stock (792195)	Indirect
2018-10-19	Series 6 Preferred Stock	$	C	652347	Disposed		Common Stock (690689)	Indirect
2018-10-19	Series 7 Preferred Stock	$	C	398676	Disposed		Common Stock (398676)	Indirect

Footnotes

F1: The Issuer's Series 4 Preferred Stock, Series 5 Preferred Stock and Series 7 Preferred Stock automatically converted into an equal number of shares of Issuer's common stock immediately upon the closing of the Issuer's initial public offering and has no expiration date.

F2: Shares held by Skyline Venture Partners V, L.P. ("SVP V"). Skyline Venture Management V, LLC ("LLC") is the general partner of SVP V and as such may be deemed to have voting and investment power with respect to the securities of SVP V. Dr. Freund, a member of the Issuer's board of directors, together with Yasunori Kaneko, are the managing directors of LLC and each may be deemed to have voting and investment power with respect to the securities held by SVP V. Dr. Freund disclaims beneficial ownership of such securities, except to the extent of his pecuniary interest therein.

F3: The Issuer's Series 6 Preferred Stock automatically converted into approximately 1.05878 shares of Issuer's common stock immediately upon the closing of the Issuer's initial public offering and has no expiration date.

F4: Shares subject to the warrant are immediately exercisable. The warrant will expire in connection with the closing of the Issuer's initial public offering.

F5: Immediately prior to the closing of the Issuer's initial public offering, SVP V exercised a warrant to purchase 39,421 shares of Series 5 Preferred Stock at an exercise price of $9.10 per share. The exercise price was paid on a net exercise cashless basis calculated using the Issuer's initial public offering price of $15.00, resulting in the Issuer withholding 23,904 of the warrant shares to pay the exercise price and issuing SVP V the remaining 15,517 shares.