0001562180-19-006116.txt : 20191216 0001562180-19-006116.hdr.sgml : 20191216 20191216204153 ACCESSION NUMBER: 0001562180-19-006116 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20191212 FILED AS OF DATE: 20191216 DATE AS OF CHANGE: 20191216 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Dearen Danny L. CENTRAL INDEX KEY: 0001756438 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38721 FILM NUMBER: 191288436 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 primarydocument.xml PRIMARY DOCUMENT X0306 4 2019-12-12 false 0001603756 Axonics Modulation Technologies, Inc. AXNX 0001756438 Dearen Danny L. 26 TECHNOLOGY DRIVE IRVINE CA 92618 false true false false See Remarks Performance-Based Restricted Stock Units 0.00 2019-12-12 4 A false 13043.00 0.00 A 2020-12-31 Common Stock 13043.00 13043.00 D Performance-Based Restricted Stock Units 0.00 2019-12-12 4 A false 13043.00 0.00 A 2021-12-31 Common Stock 13043.00 13043.00 D Stock Option (Right to Buy) 25.82 2019-12-12 4 A false 37500.00 0.00 A 2029-12-12 Common Stock 37500.00 37500.00 D Each Performance-Based Restricted Stock Unit represents the contingent right to receive one share of common stock, subject to the Issuer's achievement of certain operational and performance objectives during the fiscal year ending December 31, 2020 and provided the reporting person remains in continuous service through December 31, 2020. The number of Performance-Based Restricted Stock Units represents the target number of Performance-Based Restricted Stock Units that were granted to the reporting person on the date of grant, each of which represents the contingent right to receive one share of common stock, subject to the conditions set forth in the award agreement. Per the terms of the award agreement governing the Performance-Based Restricted Stock Units, the number of Performance-Based Restricted Stock Units to which the reporting person may ultimately become entitled ranges from 0% to 200% of the target number of Performance-Based Restricted Stock Units granted, based upon the total shareholder return of the Issuer's common stock relative to its peer group index over a performance period consisting of the two fiscal years ending December 31, 2021, and provided the reporting person remains in continuous service through December 31, 2021. 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. /s/ Danny L. Dearen 2019-12-16