0001562180-19-004194.txt : 20190806
0001562180-19-004194.hdr.sgml : 20190806
20190806175721
ACCESSION NUMBER: 0001562180-19-004194
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190806
FILED AS OF DATE: 20190806
DATE AS OF CHANGE: 20190806
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: COHEN RAYMOND W
CENTRAL INDEX KEY: 0001258288
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38721
FILM NUMBER: 191003327
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Axonics Modulation Technologies, Inc.
CENTRAL INDEX KEY: 0001603756
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 454744083
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 26 TECHNOLOGY DRIVE
CITY: IRVINE
STATE: CA
ZIP: 92618
BUSINESS PHONE: 949-396-6322
MAIL ADDRESS:
STREET 1: 26 TECHNOLOGY DRIVE
CITY: IRVINE
STATE: CA
ZIP: 92618
4
1
primarydocument.xml
PRIMARY DOCUMENT
X0306
4
2019-08-06
false
0001603756
Axonics Modulation Technologies, Inc.
AXNX
0001258288
COHEN RAYMOND W
26 TECHNOLOGY DRIVE
IRVINE
CA
92618
true
true
false
false
Chief Executive Officer
Common Stock
2019-08-06
4
P
false
3500.00
30.4111
A
683391.00
D
Common Stock
692151.00
I
See footnote
8,760 shares are held of record by Cielo Trust Established March 30, 2018 and 683,391 shares are held of record by the reporting person.
/s/ Michael V. Williamson, as Attorney-in-Fact for Raymond W. Cohen
2019-08-06