0001562180-20-005681.txt : 20200826 0001562180-20-005681.hdr.sgml : 20200826 20200826201812 ACCESSION NUMBER: 0001562180-20-005681 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200824 FILED AS OF DATE: 20200826 DATE AS OF CHANGE: 20200826 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Kiernan Jane E CENTRAL INDEX KEY: 0001379171 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38721 FILM NUMBER: 201138771 MAIL ADDRESS: STREET 1: CLINTEC, BAXTER HEALTHCARE STREET 2: ONE BAXTER PARKWAY CITY: DEERFIELD STATE: IL ZIP: 60015 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 2020-08-24 false 0001603756 Axonics Modulation Technologies, Inc. AXNX 0001379171 Kiernan Jane E 26 TECHNOLOGY DRIVE IRVINE CA 92618 true false false false Common Stock 2020-08-24 4 A false 3500.00 0.00 A 10583.00 D /s/ Dan Dearen, as Attorney-in-Fact for Jane E. Kiernan 2020-08-26