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
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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
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0.00
A
436389.00
D
Common Stock
2021-02-01
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M
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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
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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