0001562180-19-004301.txt : 20190815 0001562180-19-004301.hdr.sgml : 20190815 20190815195809 ACCESSION NUMBER: 0001562180-19-004301 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190627 FILED AS OF DATE: 20190815 DATE AS OF CHANGE: 20190815 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Tammenoms Bakker Juliet CENTRAL INDEX KEY: 0001431159 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-38721 FILM NUMBER: 191031361 MAIL ADDRESS: STREET 1: LONGITUDE CAPITAL MANAGEMENT CO., LLC STREET 2: 800 EL CAMINO REAL, SUITE 220 CITY: MENLO PARK STATE: CA ZIP: 94025 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/A 1 primarydocument.xml PRIMARY DOCUMENT X0306 4/A 2019-06-27 2019-07-01 false 0001603756 Axonics Modulation Technologies, Inc. AXNX 0001431159 Tammenoms Bakker Juliet 2740 SAND HILL RD 2ND FLOOR MENLO PARK CA 94025 true false true false Stock Option (Right to Buy) 37.15 2019-06-27 4 A false 3333.00 0.00 A 2029-06-27 Common Stock 3333.00 3333.00 D The prior form filing incorrectly reported that 5,000 stock options were granted, when the actual number of stock options granted was 3,333. This amendment is being filed to correct the error. The shares subject to the option will vest in full on August 19, 2019. /s/ Michael V. Williamson, as Attorney-in-Fact for Juliet Tammenoms Bakker 2019-08-12