0001562180-20-005206.txt : 20200722 0001562180-20-005206.hdr.sgml : 20200722 20200722215801 ACCESSION NUMBER: 0001562180-20-005206 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200720 FILED AS OF DATE: 20200722 DATE AS OF CHANGE: 20200722 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Sama Rinda CENTRAL INDEX KEY: 0001756399 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38721 FILM NUMBER: 201042610 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 2020-07-20 false 0001603756 Axonics Modulation Technologies, Inc. AXNX 0001756399 Sama Rinda 26 TECHNOLOGY DRIVE IRVINE CA 92618 false true false false Chief Operating Officer Common Stock 2020-07-20 4 M false 13657.00 1.63 A 199931.00 D Common Stock 2020-07-20 4 M false 6943.00 14.19 A 206874.00 D Common Stock 2020-07-20 4 S false 19700.00 39.3326 D 187174.00 D Common Stock 2020-07-20 4 S false 900.00 40.1894 D 186274.00 D Common Stock 2020-07-21 4 M false 13127.00 14.19 A 199401.00 D Common Stock 2020-07-21 4 S false 10400.00 40.6934 D 189001.00 D Common Stock 2020-07-21 4 S false 4000.00 41.0999 D 185001.00 D Common Stock 4000.00 I By Spouse Stock Option (Right to Buy) 14.19 2020-07-20 4 M false 6943.00 0.00 D 2029-01-30 Common Stock 6943.00 68612.00 D Stock Option (Right to Buy) 1.63 2020-07-20 4 M false 13657.00 0.00 D 2028-03-30 Common Stock 13657.00 11543.00 D Stock Option (Right to Buy) 14.19 2020-07-21 4 M false 13127.00 0.00 D 2029-01-30 Common Stock 13127.00 55485.00 D This sale was pursuant to a 10b5-1 plan adopted by the reporting person on June 18, 2020. This transaction was executed in multiple trades at prices ranging from $39.14 to $40.07. The price reported above reflects the weighted average price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected. This transaction was executed in multiple trades at prices ranging from $40.16 to $40.21. The price reported above reflects the weighted average price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected. This transaction was executed in multiple trades at prices ranging from $40.00 to $40.99. The price reported above reflects the weighted average price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected. This transaction was executed in multiple trades at prices ranging from $41.00 to $41.24. The price reported above reflects the weighted average price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected. 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 30th, 2020, and the remainder vesting at a rate of 1/36th per month commencing upon the one-year anniversary of January 30th, 2020, 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, 2018, and the remainder vesting at a rate of 1/36th per month commencing upon the one-year anniversary of March 30, 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. /s/ Dan Dearen, as Attorney-in-Fact for Rinda Sama 2020-07-22