4//SEC Filing
Skyline Venture Partners V LP 4
Accession 0001209191-18-055698
CIK 0001459839other
Filed
Oct 18, 8:00 PM ET
Accepted
Oct 19, 4:48 PM ET
Size
34.7 KB
Accession
0001209191-18-055698
Insider Transaction Report
Form 4
SI-BONE, Inc.SIBN
Skyline Venture Partners V LP
10% Owner
Transactions
- Conversion
Series 6 Preferred Stock
2018-10-19−652,347→ 0 total(indirect: By Skyline Venture Partners V, L.P.)→ Common Stock (690,689 underlying) - Conversion
Common Stock
2018-10-19+398,676→ 4,094,985 total(indirect: By Skyline Venture Partners V, L.P.) - Conversion
Common Stock
2018-10-19+792,195→ 3,005,620 total(indirect: By Skyline Venture Partners V, L.P.) - Purchase
Common Stock
2018-10-19$15.00/sh+325,000$4,875,000→ 4,419,985 total(indirect: By Skyline Venture Partners V, L.P.) - Conversion
Series 4 Preferred Stock
2018-10-19−2,213,425→ 0 total(indirect: By Skyline Venture Partners V, L.P.)→ Common Stock (2,213,425 underlying) - Exercise of In-Money
Series 5 Preferred Stock
2018-10-19+39,421→ 816,099 total(indirect: By Skyline Venture Partners V, L.P.)Exercise: $9.10→ Common Stock (39,421 underlying) - Sale
Series 5 Preferred Stock
2018-10-19$14.00/sh−23,904$334,656→ 792,195 total(indirect: By Skyline Venture Partners V, L.P.)→ Common Stock (23,904 underlying) - Conversion
Series 7 Preferred Stock
2018-10-19−398,676→ 0 total(indirect: By Skyline Venture Partners V, L.P.)→ Common Stock (398,676 underlying) - Conversion
Common Stock
2018-10-19+2,213,425→ 2,213,425 total(indirect: By Skyline Venture Partners V, L.P.) - Conversion
Common Stock
2018-10-19+690,689→ 3,696,309 total(indirect: By Skyline Venture Partners V, L.P.) - Exercise of In-Money
Warrant (right to buy)
2018-10-19−39,421→ 0 total(indirect: By Skyline Venture Partners V, L.P.)Exercise: $9.10→ Series 5 Preferred Stock (39,421 underlying) - Conversion
Series 5 Preferred Stock
2018-10-19−792,195→ 0 total(indirect: By Skyline Venture Partners V, L.P.)→ Common Stock (792,195 underlying)
Skyline Venture Management V, LLC
10% Owner
Transactions
- Conversion
Common Stock
2018-10-19+690,689→ 3,696,309 total(indirect: By Skyline Venture Partners V, L.P.) - Purchase
Common Stock
2018-10-19$15.00/sh+325,000$4,875,000→ 4,419,985 total(indirect: By Skyline Venture Partners V, L.P.) - Exercise of In-Money
Series 5 Preferred Stock
2018-10-19+39,421→ 816,099 total(indirect: By Skyline Venture Partners V, L.P.)Exercise: $9.10→ Common Stock (39,421 underlying) - Conversion
Series 7 Preferred Stock
2018-10-19−398,676→ 0 total(indirect: By Skyline Venture Partners V, L.P.)→ Common Stock (398,676 underlying) - Conversion
Common Stock
2018-10-19+2,213,425→ 2,213,425 total(indirect: By Skyline Venture Partners V, L.P.) - Conversion
Series 4 Preferred Stock
2018-10-19−2,213,425→ 0 total(indirect: By Skyline Venture Partners V, L.P.)→ Common Stock (2,213,425 underlying) - Conversion
Series 6 Preferred Stock
2018-10-19−652,347→ 0 total(indirect: By Skyline Venture Partners V, L.P.)→ Common Stock (690,689 underlying) - Conversion
Common Stock
2018-10-19+792,195→ 3,005,620 total(indirect: By Skyline Venture Partners V, L.P.) - Conversion
Common Stock
2018-10-19+398,676→ 4,094,985 total(indirect: By Skyline Venture Partners V, L.P.) - Exercise of In-Money
Warrant (right to buy)
2018-10-19−39,421→ 0 total(indirect: By Skyline Venture Partners V, L.P.)Exercise: $9.10→ Series 5 Preferred Stock (39,421 underlying) - Sale
Series 5 Preferred Stock
2018-10-19$14.00/sh−23,904$334,656→ 792,195 total(indirect: By Skyline Venture Partners V, L.P.)→ Common Stock (23,904 underlying) - Conversion
Series 5 Preferred Stock
2018-10-19−792,195→ 0 total(indirect: By Skyline Venture Partners V, L.P.)→ Common Stock (792,195 underlying)
KANEKO YASUNORI
10% Owner
Transactions
- Conversion
Series 6 Preferred Stock
2018-10-19−652,347→ 0 total(indirect: By Skyline Venture Partners V, L.P.)→ Common Stock (690,689 underlying) - Conversion
Common Stock
2018-10-19+690,689→ 3,696,309 total(indirect: By Skyline Venture Partners V, L.P.) - Exercise of In-Money
Series 5 Preferred Stock
2018-10-19+39,421→ 816,099 total(indirect: By Skyline Venture Partners V, L.P.)Exercise: $9.10→ Common Stock (39,421 underlying) - Conversion
Common Stock
2018-10-19+2,213,425→ 2,213,425 total(indirect: By Skyline Venture Partners V, L.P.) - Exercise of In-Money
Warrant (right to buy)
2018-10-19−39,421→ 0 total(indirect: By Skyline Venture Partners V, L.P.)Exercise: $9.10→ Series 5 Preferred Stock (39,421 underlying) - Sale
Series 5 Preferred Stock
2018-10-19$14.00/sh−23,904$334,656→ 792,195 total(indirect: By Skyline Venture Partners V, L.P.)→ Common Stock (23,904 underlying) - Conversion
Series 5 Preferred Stock
2018-10-19−792,195→ 0 total(indirect: By Skyline Venture Partners V, L.P.)→ Common Stock (792,195 underlying) - Conversion
Series 7 Preferred Stock
2018-10-19−398,676→ 0 total(indirect: By Skyline Venture Partners V, L.P.)→ Common Stock (398,676 underlying) - Conversion
Common Stock
2018-10-19+792,195→ 3,005,620 total(indirect: By Skyline Venture Partners V, L.P.) - Conversion
Common Stock
2018-10-19+398,676→ 4,094,985 total(indirect: By Skyline Venture Partners V, L.P.) - Purchase
Common Stock
2018-10-19$15.00/sh+325,000$4,875,000→ 4,419,985 total(indirect: By Skyline Venture Partners V, L.P.) - Conversion
Series 4 Preferred Stock
2018-10-19−2,213,425→ 0 total(indirect: By Skyline Venture Partners V, L.P.)→ Common Stock (2,213,425 underlying)
Freund John Gordon
Director
Transactions
- Exercise of In-Money
Series 5 Preferred Stock
2018-10-19+39,421→ 816,099 total(indirect: By Skyline Venture Partners V, L.P.)Exercise: $9.10→ Common Stock (39,421 underlying) - Sale
Series 5 Preferred Stock
2018-10-19$14.00/sh−23,904$334,656→ 792,195 total(indirect: By Skyline Venture Partners V, L.P.)→ Common Stock (23,904 underlying) - Conversion
Common Stock
2018-10-19+2,213,425→ 2,213,425 total(indirect: By Skyline Venture Partners V, L.P.) - Conversion
Common Stock
2018-10-19+398,676→ 4,094,985 total(indirect: By Skyline Venture Partners V, L.P.) - Exercise of In-Money
Warrant (right to buy)
2018-10-19−39,421→ 0 total(indirect: By Skyline Venture Partners V, L.P.)Exercise: $9.10→ Series 5 Preferred Stock (39,421 underlying) - Conversion
Common Stock
2018-10-19+792,195→ 3,005,620 total(indirect: By Skyline Venture Partners V, L.P.) - Conversion
Common Stock
2018-10-19+690,689→ 3,696,309 total(indirect: By Skyline Venture Partners V, L.P.) - Purchase
Common Stock
2018-10-19$15.00/sh+325,000$4,875,000→ 4,419,985 total(indirect: By Skyline Venture Partners V, L.P.) - Conversion
Series 7 Preferred Stock
2018-10-19−398,676→ 0 total(indirect: By Skyline Venture Partners V, L.P.)→ Common Stock (398,676 underlying) - Conversion
Series 4 Preferred Stock
2018-10-19−2,213,425→ 0 total(indirect: By Skyline Venture Partners V, L.P.)→ Common Stock (2,213,425 underlying) - Conversion
Series 5 Preferred Stock
2018-10-19−792,195→ 0 total(indirect: By Skyline Venture Partners V, L.P.)→ Common Stock (792,195 underlying) - Conversion
Series 6 Preferred Stock
2018-10-19−652,347→ 0 total(indirect: By Skyline Venture Partners V, L.P.)→ Common Stock (690,689 underlying)
Footnotes (5)
- [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. John G. 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 and Mr. Kaneko disclaim beneficial ownership of such securities, except to the extent of their 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.
Documents
Issuer
SI-BONE, Inc.
CIK 0001459839
Entity typeother
IncorporatedDE
Related Parties
1- filerCIK 0001419187
Filing Metadata
- Form type
- 4
- Filed
- Oct 18, 8:00 PM ET
- Accepted
- Oct 19, 4:48 PM ET
- Size
- 34.7 KB