0001562180-21-002904.txt : 20210421 0001562180-21-002904.hdr.sgml : 20210421 20210421211930 ACCESSION NUMBER: 0001562180-21-002904 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210419 FILED AS OF DATE: 20210421 DATE AS OF CHANGE: 20210421 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Ford Alfred J Jr CENTRAL INDEX KEY: 0001359446 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38721 FILM NUMBER: 21843013 MAIL ADDRESS: STREET 1: 3303 MONTE VILLA PARKWAY CITY: BOTHELL STATE: WA ZIP: 98021 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Axonics, 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 FORMER COMPANY: FORMER CONFORMED NAME: Axonics Modulation Technologies, Inc. DATE OF NAME CHANGE: 20140326 4 1 primarydocument.xml PRIMARY DOCUMENT X0306 4 2021-04-19 false 0001603756 Axonics, Inc. AXNX 0001359446 Ford Alfred J Jr 26 TECHNOLOGY DRIVE IRVINE CA 92618 false true false false Chief Commercial Officer Common Stock 2021-04-19 4 M false 14871.00 1.42 A 28595.00 D Common Stock 2021-04-19 4 M false 5721.00 1.63 A 34316.00 D Common Stock 2021-04-19 4 M false 19258.00 14.19 A 53574.00 D Common Stock 2021-04-19 4 M false 6347.00 25.82 A 59921.00 D Common Stock 2021-04-19 4 S false 41794.00 58.3268 D 18127.00 D Common Stock 2021-04-19 4 S false 12502.00 59.3262 D 5625.00 D Stock Option (Right to Buy) 25.82 2021-04-19 4 M false 6347.00 0.00 D 2029-12-12 Common Stock 6347.00 13965.00 D Stock Option (Right to Buy) 14.19 2021-04-19 4 M false 19258.00 0.00 D 2029-01-30 Common Stock 19258.00 16297.00 D Stock Option (Right to Buy) 1.63 2021-04-19 4 M false 5721.00 0.00 D 2028-03-30 Common Stock 5721.00 1899.00 D Stock Option (Right to Buy) 1.42 2021-04-19 4 M false 14871.00 0.00 D 2027-11-15 Common Stock 14871.00 8509.00 D The sale was effected pursuant to the Reporting Person's Rule 10b5-1 trading plan This transaction was executed in multiple trades at prices ranging from $57.87 to $58.85. 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 $58.87 to $59.80. 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 option becomes exercisable as follows: (i) 1/4 of the total number of shares of common stock underlying the option will vest on December 12, 2020 and (ii) 1/36 of the remaining shares of common stock underlying the option will vest monthly thereafter, such that the option will fully vest on December 12, 2023, provided the reporting person remains in continuous service on each vesting date. The option becomes exercisable as follows: (i) 1/4 of the total number of shares of common stock underlying the option will vest on January 30, 2020 and (ii) 1/36 of the remaining shares of common stock underlying the option will vest monthly thereafter, such that the option will fully vest on January 30, 2023, provided the reporting person remains in continuous service on each vesting date. 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 four years, with 1/4th of the shares subject to the option vesting on November 15, 2017 and the remainder vesting at a rate of 1/36th per month commencing upon the one-year anniversary of November 15, 2017, 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. /s/ Dan Dearen, as Attorney-in-Fact for Alfred J. Ford, Jr. 2021-04-21