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SI-BONE, Inc. — Director's Dealing 2018
Oct 16, 2018
32647_dirs_2018-10-16_c079ba8a-7538-4186-b8ee-326ad966d84e.zip
Director's Dealing
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SEC Form 3 — Initial Statement of Beneficial Ownership
Issuer: SI-BONE, Inc. (SIBN)
CIK: 0001459839
Period of Report: 2018-10-16
Reporting Person: Montreux Equity Partners IV, L.P. (10% Owner)
Reporting Person: Montreux IV Associates, LLC (10% Owner)
Reporting Person: Montreux IV Associates IV, LLC (10% Owner)
Reporting Person: Montreux Equity Management IV, LLC (10% Owner)
Reporting Person: TURNER DANIEL K III (10% Owner)
Holdings (Derivative)
| Security | Exercise Price | Expiration | Underlying | Shares | Ownership |
|---|---|---|---|---|---|
| Series 5 Preferred Stock | $ | Common Stock (1096816) | Indirect | ||
| Series 5 Preferred Stock | $ | Common Stock (78564) | Indirect | ||
| Series 6 Preferred Stock | $ | Common Stock (563926) | Indirect | ||
| Series 6 Preferred Stock | $ | Common Stock (48950) | Indirect | ||
| Series 7 Preferred Stock | $ | Common Stock (27409) | Indirect | ||
| Series 7 Preferred Stock | $ | Common Stock (171929) | Indirect | ||
| Warrant (right to buy) | $9.10 | Series 5 Preferred Stock (15496) | Indirect |
Footnotes
F1: The Issuer's Series 4 Preferred Stock, Series 5 Preferred Stock and Series 7 Preferred Stock will automatically convert 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: Montreux Equity Management IV, L.L.C. ("MEM IV LLC") is the general partner of each of Montreux Equity Partners IV, L.P., Montreux IV Associates, L.L.C and Montreux IV Associates IV, L.L.C. Daniel K. Turner III is the managing director of MEM IV LLC and may be deemed to have voting and investment power over the shares held by each of these entities. Mr. Turner disclaims beneficial ownership of such shares, except to the extent of his proportionate pecuniary interest, if any.
F3: The Issuer's Series 6 Preferred Stock will automatically convert 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.