0001562180-20-005776.txt : 20200902
0001562180-20-005776.hdr.sgml : 20200902
20200902194409
ACCESSION NUMBER: 0001562180-20-005776
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200831
FILED AS OF DATE: 20200902
DATE AS OF CHANGE: 20200902
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Ford Alfred J Jr
CENTRAL INDEX KEY: 0001359446
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38721
FILM NUMBER: 201158048
MAIL ADDRESS:
STREET 1: 3303 MONTE VILLA PARKWAY
CITY: BOTHELL
STATE: WA
ZIP: 98021
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
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2020-08-31
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0001603756
Axonics Modulation Technologies, Inc.
AXNX
0001359446
Ford Alfred J Jr
26 TECHNOLOGY DRIVE
IRVINE
CA
92618
false
true
false
false
Chief Commercial Officer
Common Stock
2020-08-31
4
S
false
2667.00
42.3116
D
0.00
D
Common Stock
2020-09-02
4
M
false
35000.00
1.42
A
35000.00
D
Common Stock
2020-09-02
4
S
false
11031.00
39.8447
D
23969.00
D
Common Stock
2020-09-02
4
S
false
23743.00
40.4062
D
226.00
D
Common Stock
2020-09-02
4
S
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226.00
41.3229
D
0.00
D
Stock Option (Right to Buy)
1.42
2020-09-02
4
M
false
35000.00
0.00
D
2027-11-15
Common Stock
35000.00
23380.00
D
This transaction was executed in multiple trades at prices ranging from $42.31 to $42.3401. The price reported above reflects the weighted average price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected.
This transaction was executed in multiple trades at prices ranging from $39.21 to $40.20. The price reported above reflects the weighted average price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected.
This transaction was executed in multiple trades at prices ranging from $40.21 to $40.91. The price reported above reflects the weighted average price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected.
This transaction was executed in multiple trades at prices ranging from $41.23 to $41.35. The price reported above reflects the weighted average price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected.
The shares subject to the option will vest over a period of four years, with 1/4th of the shares subject to the option vesting on November 15, 2017 and the remainder vesting at a rate of 1/36th per month commencing upon the one-year anniversary of November 15, 2017, provided the reporting person remains in continuous service on each vesting date, subject to accelerated vesting in certain events, including upon certain changes of control of the Issuer. The option is subject to an early exercise provision and is immediately exercisable.
/s/ Dan Dearen, as Attorney-in-Fact for Alfred J. Ford, Jr.
2020-09-02