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: Davis Timothy E JR (Director)

Holdings (Derivative)

Security	Exercise Price	Expiration	Underlying	Shares	Ownership
Series 6 Preferred Stock	$		Common Stock (6070)		Direct
Stock Option (right to buy)	$3.24	2024-01-16	Common Stock (21111)		Direct
Stock Option (right to buy)	$4.32	2026-07-26	Common Stock (12064)		Direct
Stock Option (right to buy)	$5.94	2027-03-01	Common Stock (22222)		Direct

Footnotes

F1: 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.

F2: The shares subject to the option are fully vested and immediately exercisable.

F3: The shares subject to the option vest in equal monthly installments over four years commencing on June 2, 2016, subject to Reporting Person's continued service through each relevant vesting date. The shares subject to this option may be exercised prior to vesting, subject to Issuer's right to repurchase.

F4: The shares subject to the option vest in equal monthly installments over three years commencing on the closing date of the Issuer's initial public offering, subject to Reporting Person's continued service through each relevant vesting date.