SI-BONE, Inc.·4

Oct 19, 4:58 PM ET

Petersen Timothy 4

4 · SI-BONE, Inc. · Filed Oct 19, 2018

Insider Transaction Report

Form 4
Period: 2018-10-19
Transactions
  • Conversion

    Common Stock

    2018-10-19+1,495,0361,495,036 total(indirect: By Arboretum Ventures IV, LP)
  • Conversion

    Series 7 Preferred Stock

    2018-10-191,495,0360 total(indirect: By Arboretum Ventures IV, LP)
    Common Stock (1,495,036 underlying)
  • Purchase

    Common Stock

    2018-10-19$15.00/sh+200,000$3,000,0001,695,036 total(indirect: By Arboretum Ventures IV, LP)
Footnotes (2)
  • [F1]The Issuer's 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 Arboretum Ventures IV, LP ("AV IV"). Arboretum Investment Manager IV, LLC ("AIM IV") serves as the general partner of AV IV. Jan Garfinkle, Timothy B. Petersen, a member of the Issuer's board of directors, and Paul McCreadie are managing members of AIM IV and share voting and dispositive power with regard to these shares and therefore each of the foregoing managing members may be deemed to have the same powers with respect to such shares. Mr. Petersen disclaims beneficial ownership of such shares except to the extent of his proportionate pecuniary interest, if any.

Documents

1 file
  • 4
    doc4.xmlPrimary

    FORM 4 SUBMISSION