0001562180-19-005751.txt : 20191126 0001562180-19-005751.hdr.sgml : 20191126 20191126210713 ACCESSION NUMBER: 0001562180-19-005751 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20191122 FILED AS OF DATE: 20191126 DATE AS OF CHANGE: 20191126 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BioDiscovery 4 FCPR CENTRAL INDEX KEY: 0001756321 STATE OF INCORPORATION: I0 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38721 FILM NUMBER: 191252973 BUSINESS ADDRESS: STREET 1: 374 RUE SAINT-HONORE CITY: PARIS STATE: I0 ZIP: 75001 BUSINESS PHONE: 949-396-6322 MAIL ADDRESS: STREET 1: 374 RUE SAINT-HONORE CITY: PARIS STATE: I0 ZIP: 75001 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Andera Partners CENTRAL INDEX KEY: 0001757283 STATE OF INCORPORATION: I0 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38721 FILM NUMBER: 191252974 BUSINESS ADDRESS: STREET 1: 374 RUE SAINT ST HONORE CITY: PARIS STATE: I0 ZIP: 75001 BUSINESS PHONE: 33-1-85-73-6603 MAIL ADDRESS: STREET 1: 374 RUE SAINT ST HONORE CITY: PARIS STATE: I0 ZIP: 75001 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 2019-11-22 true 0001603756 Axonics Modulation Technologies, Inc. AXNX 0001757283 Andera Partners 374 RUE SAINT ST HONORE ST. 75001 PARIS false false true false 0001756321 BioDiscovery 4 FCPR 374 RUE SAINT ST HONORE ST. 75001 PARIS false false true false Common Stock 2019-11-22 4 S false 300000.00 20.735 D 3257461.00 I See footnote The shares were sold in a public offering pursuant to the Registration Statement of Axonics Modulation Technologies, Inc. on Form S-3 (File No. 333-234546) 2,524,128 shares are held of record by BioDiscovery 4 FCPR ("BioDiscovery") and 733,333 shares are held of record by BioDiscovery 5 ("BioDiscovery 5"). Andera Partners ("Andera") is the manager of BioDiscovery and BioDiscovery 5 and may be deemed to have sole voting and dispositive power over the shares held by BioDiscovery and BioDiscovery 5. /s/ Aichatou DIOP for Andera Partners 2019-11-26 /s/ Aichatou DIOP for BioDiscovery 4 FCPR 2019-11-26