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

Oct 16, 2018

SEC Form 3 — Initial Statement of Beneficial Ownership

Issuer: SI-BONE, Inc. (SIBN)
CIK: 0001459839
Period of Report: 2018-10-16

Reporting Person: Reiley Mark A (Director)

Holdings (Non-Derivative)

Security	Shares	Ownership
Common Stock	514500	Direct
Common Stock	19444	Indirect

Holdings (Derivative)

Security	Exercise Price	Expiration	Underlying	Shares	Ownership
Series 3 Preferred Stock	$		Common Stock (8680)		Direct

Footnotes

F1: Shares held by The Mark and Muriel Riley Charitable Remainder Unitrust.

F2: The Issuer's Series 3 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.