X0306 4 2018-12-06 0 0001603756 Axonics Modulation Technologies, Inc. AXNX 0001431159 Tammenoms Bakker Juliet 2740 SAND HILL RD 2ND FLOOR MENLO PARK CA 94025 1 0 1 0 Common Stock 2018-12-06 4 A 0 2500 0.00 A 2500 D Common Stock 2933333 I By Longitude Venture Partners III, L.P. Stock Option (Right to Buy) 14.80 2018-12-06 4 A 0 5000 0.00 A 2028-12-06 Common Stock 5000 5000 D 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. Ms. Tammenoms Bakker, 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, (Continued from Footnote 1) except to the extent of their respective pecuniary interests therein. The shares subject to the option will vest in full on April 30, 2019. /s/ Michael V. Williamson, as Attorney-in-Fact for Juliet Tammenoms Bakker 2018-12-10