0001562180-19-004069.txt : 20190725 0001562180-19-004069.hdr.sgml : 20190725 20190725193526 ACCESSION NUMBER: 0001562180-19-004069 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190723 FILED AS OF DATE: 20190725 DATE AS OF CHANGE: 20190725 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Noblett Karen CENTRAL INDEX KEY: 0001756240 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38721 FILM NUMBER: 19975683 MAIL ADDRESS: STREET 1: 26 TECHNOLOGY DRIVE CITY: IRVINE STATE: CA ZIP: 92618 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 2019-07-23 false 0001603756 Axonics Modulation Technologies, Inc. AXNX 0001756240 Noblett Karen 26 TECHNOLOGY DRIVE IRVINE CA 92618 false true false false Chief Medical Officer Common Stock 2019-07-23 4 M false 8402.00 0.98 A 48122.00 D Common Stock 2019-07-23 4 M false 6002.00 1.63 A 54124.00 D Stock Option (Right to Buy) 1.63 2019-07-23 4 M false 6002.00 0.00 D 2028-03-30 Common Stock 6002.00 11998.00 D Stock Option (Right to Buy) 0.98 2019-07-23 4 M false 8402.00 0.00 D 2026-01-15 Common Stock 8402.00 1198.00 D 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 March 30, 2018 and the remainder vesting at a rate of 1/36th per month commencing upon the one-year anniversary of March 30, 2018, 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. The shares subject to the option will vest over a period of three years, with 1/4th of the shares subject to the option vesting on January 15, 2016, and the remainder vesting at a rate of 1/36th per month thereafter, 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. /s/ Michael V. Williamson, as Attorney-in-Fact for Karen Noblett, M.D. 2019-07-25