0001562180-21-000757.txt : 20210202 0001562180-21-000757.hdr.sgml : 20210202 20210202205039 ACCESSION NUMBER: 0001562180-21-000757 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210131 FILED AS OF DATE: 20210202 DATE AS OF CHANGE: 20210202 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: COHEN RAYMOND W CENTRAL INDEX KEY: 0001258288 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38721 FILM NUMBER: 21583839 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 2021-01-31 false 0001603756 Axonics Modulation Technologies, Inc. AXNX 0001258288 COHEN RAYMOND W 26 TECHNOLOGY DRIVE IRVINE CA 92618 true true false false Chief Executive Officer Common Stock 2021-01-31 4 A false 20000.00 0.00 A 436389.00 D Common Stock 2021-02-01 4 M false 33334.00 0.00 A 469723.00 D Common Stock 2021-02-01 4 S false 12675.00 51.3645 D 457048.00 D Common Stock 2021-02-01 4 S false 952.00 52.1179 D 456096.00 D Performance-Based Restricted Stock Units 2021-01-31 4 A false 20000.00 0.00 A 2022-01-31 Common Stock 20000.00 20000.00 D Performance-Based Restricted Stock Units 2021-01-31 4 A false 42500.00 0.00 A 2023-01-31 Common Stock 42500.00 42500.00 D Performance-Based Restricted Stock Units 2021-02-01 4 M false 16667.00 0.00 D Common Stock 33334.00 0.00 D The number of Performance-Based Restricted Stock Units represents the target number of Performance-Based Restricted Stock Units that were granted to the reporting person on the date of grant, each of which represents the contingent right to receive one share of common stock, subject to the conditions set forth in the award agreement. Per the terms of the award agreement governing the Performance-Based Restricted Stock Units, the number of Performance-Based Restricted Stock Units to which the reporting person may ultimately become entitled ranges from 0% to 200% of the target number of Performance-Based Restricted Stock Units granted, based upon the total shareholder return of the Issuer's common stock relative to its peer group index over a performance period consisting of the two fiscal years ending December 31, 2020, and provided the reporting person remains in continuous service through January 30, 2021. The awards were earned at 200% of the target number on January 31, 2021. Shares of Issuer's common stock sold to cover the reporting person's tax obligation in connection with the conversion of the Performance-Based Restricted Stock Units disclosed herein. This transaction was executed in multiple trades at prices ranging from $51.03 to $52.00. The price reported above reflects the weighted average price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected. This transaction was executed in multiple trades at prices ranging from $52.04 to $52.28. The price reported above reflects the weighted average price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected. The number of Performance-Based Restricted Stock Units represents the target number of Performance-Based Restricted Stock Units that were granted to the reporting person on the date of grant, each of which represents the contingent right to receive one share of common stock, subject to the conditions set forth in the award agreement. Per the terms of the award agreement governing the Performance-Based Restricted Stock Units, the number of Performance-Based Restricted Stock Units to which the reporting person may ultimately become entitled ranges from 0% to 200% of the target number of Performance-Based Restricted Stock Units granted, based upon the total shareholder return of the Issuer's common stock relative to its peer group index over a performance period consisting of the two fiscal years ending January 31, 2023, and provided the reporting person remains in continuous service through January 31, 2023. Each Performance-Based Restricted Stock Unit represents the contingent right to receive one share of common stock, subject to the Issuer's achievement of certain operational and performance objectives during the fiscal year ending December 31, 2021 and provided the reporting person remains in continuous service through January 31, 2022. /s/ Dan Dearen, as Attorney-in-Fact for Raymond W. Cohen 2021-02-02