X0306 4 2018-12-06 0 0001603756 Axonics Modulation Technologies, Inc. AXNX 0001756338 Pardo Geoff 26 TECHNOLOGY DRIVE IRVINE CA 92618 1 0 1 0 Common Stock 2018-12-06 4 A 0 2500 0.00 A 2500 D Common Stock 3133332 I By Cooperatieve Gilde Healthcare IV U.A. 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 The shares are held directly by Cooperatieve Gilde Healthcare IV U.A. ("Gilde"). The reporting person, who is a member of the Issuer's board of directors, is a partner of Gilde. Gilde is managed by Gilde Healthcare IV Management B.V. ("Management"). Management is owned by Gilde Healthcare Holding B.V. ("Holding"). Each of the reporting person, Management and Holding may be deemed to have voting, investment and dispositive power with respect to these securities. Each of the reporting person, (Continued from Footnote 1) Management and Holding 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. The shares subject to the option will vest in full on April 30, 2019. /s/ Michael V. Williamson, as Attorney-in-Fact for Geoff Pardo 2018-12-10