0000899243-20-025932.txt : 20200922 0000899243-20-025932.hdr.sgml : 20200922 20200922180142 ACCESSION NUMBER: 0000899243-20-025932 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200918 FILED AS OF DATE: 20200922 DATE AS OF CHANGE: 20200922 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Tammenoms Bakker Juliet CENTRAL INDEX KEY: 0001431159 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38721 FILM NUMBER: 201190468 MAIL ADDRESS: STREET 1: LONGITUDE CAPITAL MANAGEMENT CO., LLC STREET 2: 800 EL CAMINO REAL, SUITE 220 CITY: MENLO PARK STATE: CA ZIP: 94025 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 doc4.xml FORM 4 SUBMISSION X0306 4 2020-09-18 0 0001603756 Axonics Modulation Technologies, Inc. AXNX 0001431159 Tammenoms Bakker Juliet 2740 SAND HILL RD 2ND FLOOR MENLO PARK CA 94025 1 0 0 0 Common Stock 2020-09-18 4 S 0 9167 42.666 D 3500 D Common Stock 1955333 I By Longitude Venture Partners III, L.P. Common Stock 1026 I See Footnote The price reported in Column 4 is a weighted average price. These securities were sold in multiple transactions at prices ranging from $42.36 to $43.18, inclusive. The Reporting Person undertakes to provide to the Issuer, any security holder of the Issuer or the staff of the Securities Exchange Commission, upon request, full information regarding the number of securities sold at each separate price within the ranges set forth in this footnote (1) to this Form 4. These shares are held directly by Longitude Venture Partners III, L.P. ("Longitude Venture III"). Longitude Capital Partners III, LLC ("Longitude Capital III"), is the general partner of Longitude Venture III and may be deemed to have voting, investment and dispositive power with respect to these securities. The Reporting Person, who is a member of the Issuer's board of directors, and Patrick G. Enright are the managing members of Longitude Capital III (each a "Manager" and collectively, the "Managers"), and may each be deemed to share voting, investment and dispositive power with respect to these securities. Each of Longitude Capital III and the Managers disclaims beneficial ownership of these securities and this report shall not be deemed an admission that any of them is the beneficial owner of such securities for purposes of Section 16 or for any other purpose, except to the extent of their respective pecuniary interests therein. These shares are held by a trust. The Reporting Person is the Investment Trustee of such trust and may be deemed to share voting and dispositive power with regard to the reported shares. The Reporting Person disclaims beneficial ownership of such share except to the extent of her pecuniary interest therein. /s/ Juliet Tammenoms Bakker 2020-09-22