0001562180-19-002781.txt : 20190513
0001562180-19-002781.hdr.sgml : 20190513
20190513193350
ACCESSION NUMBER: 0001562180-19-002781
CONFORMED SUBMISSION TYPE: 3/A
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20181030
FILED AS OF DATE: 20190513
DATE AS OF CHANGE: 20190513
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Sama Rinda
CENTRAL INDEX KEY: 0001756399
FILING VALUES:
FORM TYPE: 3/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38721
FILM NUMBER: 19820103
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
3/A
1
primarydocument.xml
PRIMARY DOCUMENT
X0206
3/A
2018-10-30
2018-10-30
0
0001603756
Axonics Modulation Technologies, Inc.
AXNX
0001756399
Sama Rinda
26 TECHNOLOGY DRIVE
IRVINE
CA
92618
false
true
false
false
Chief Operating Officer
Stock Options (Right to buy)
0.97
2024-06-29
Common Stock
1800.00
I
By Spouse
Stock Options (Right to buy)
0.97
2025-04-01
Common Stock
1800.00
I
By Spouse
Stock Options (Right to buy)
0.98
2026-01-15
Common Stock
7472.00
I
By Spouse
Stock Options (Right to buy)
1.32
2027-05-22
Common Stock
1870.00
I
By Spouse
Stock Options (Right to buy)
1.32
2027-07-05
Common Stock
1040.00
I
By Spouse
Stock Options (Right to buy)
1.42
2027-08-25
Common Stock
1892.00
I
By Spouse
Stock Options (Right to buy)
1.63
2028-03-30
Common Stock
4200.00
I
By Spouse
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 June 30, 2015 and the remainder vesting at a rate of 1/36th per month commencing upon the one-year anniversary of June 30, 2015, 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.
These options were omitted from the reporting person's original Form 3.
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 April 2, 2016 and the remainder vesting at a rate of 1/36th per month commencing upon the one-year anniversary of April 2, 2016, 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 January 15, 2017 and the remainder vesting at a rate of 1/36th per month commencing upon the one-year anniversary of January 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.
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 May 23, 2018 and the remainder vesting at a rate of 1/36th per month commencing upon the one-year anniversary of May 23, 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 July 5, 2018 and the remainder vesting at a rate of 1/36th per month commencing upon the one-year anniversary of July 5, 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 July 21, 2018 and the remainder vesting at a rate of 1/36th per month commencing upon the one-year anniversary of July 21, 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 March 30, 2019 and the remainder vesting at a rate of 1/36th per month commencing upon the one-year anniversary of March 30, 2019, 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/ Michael V. Williamson, as Attorney-in-Fact for Rinda Sama
2019-05-10