0000899243-19-028812.txt : 20191210
0000899243-19-028812.hdr.sgml : 20191210
20191210134300
ACCESSION NUMBER: 0000899243-19-028812
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191121
FILED AS OF DATE: 20191210
DATE AS OF CHANGE: 20191210
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Pardo Geoff
CENTRAL INDEX KEY: 0001756338
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38721
FILM NUMBER: 191277210
MAIL ADDRESS:
STREET 1: 26 TECHNOLOGY DRIVE
CITY: IRVINE
STATE: CA
ZIP: 92618
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
doc4.xml
FORM 4 SUBMISSION
X0306
4
2019-11-21
1
0001603756
Axonics Modulation Technologies, Inc.
AXNX
0001756338
Pardo Geoff
26 TECHNOLOGY DRIVE
IRVINE
CA
92618
0
0
0
1
Former 10% Owner
The reporting person is filing this exit Form 4 to reflect that he is no longer a 10% owner of the issuer. The ownership percentage of the reporting person is based on the number of shares reported by the issuer to be outstanding immediately after the closing of the issuer's offering on the issuer's prospectus filed with the Securities and Exchange Commission on November 21, 2019.
/s/ Geoff Pardo
2019-12-10