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Filing Details

Issuer

Cik	Name	Symbol	Sector (SIC)	IRS No
1459839	Si-Bone Inc.	SIBN	Surgical & Medical Instruments & Apparatus (3841)	262216351

Insiders

Cik	Name	Reported Address	Insider Title	Director	Officer	Large Shareholder	Other
1592730	Timothy Petersen	C/O Arboretum Ventures 303 Detroit Street, Suite 301 Ann Arbor MI 48104		Yes	No	No	No

Reported Non-Derivative Transactions

Sec. Name	Acquisiton - Disposition	Date	Amount	Price	Remaning Holdings	Equity Swap Involved	Form Type	Code	Nature of Ownership	Explanation
Common Stock	Acquisiton	2018-10-19	1,495,036	$0.00	1,495,036	No	4	C	Indirect	By Arboretum Ventures IV, LP
Common Stock	Acquisiton	2018-10-19	200,000	$15.00	1,695,036	No	4	P	Indirect	By Arboretum Ventures IV, LP

Equity Swap Involved	Form Type	Code	Nature of Ownership	Explanation
No	4	C	Indirect	By Arboretum Ventures IV, LP
No	4	P	Indirect	By Arboretum Ventures IV, LP

Reported Derivative Transactions

Sec. Name	Sec. Type	Acquisiton - Disposition	Date	Amount	Price	Amount - 2	Price - 2
Common Stock	Series 7 Preferred Stock	Disposition	2018-10-19	1,495,036	$0.00	1,495,036	$0.00

Remaning Holdings	Exercise Date	Expiration Date	Equity Swap Involved	Transaction Form Type	Transaction Code	Nature of Ownership
0			No	4	C	Indirect

Footnotes

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.
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.