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
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2019-07-23
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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
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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