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Filing Details

Accession Number:: 0001562180-19-002783
Form Type:: 4
Zero Holdings:: No
Publication Time:: 2019-05-13 19:40:21
Reporting Period:: 2019-05-09

Accepted Time:: 2019-05-13 19:40:21
SEC Url:: Form 4 Filing

Issuer

Cik	Name	Symbol	Sector (SIC)	IRS No
1603756	Axonics Modulation Technologies Inc.	AXNX	Surgical & Medical Instruments & Apparatus (3841)	454744083

Insiders

Cik	Name	Reported Address	Insider Title	Director	Officer	Large Shareholder	Other
1756399	Rinda Sama	26 Technology Drive Irvine CA 92618	Chief Operating Officer	No	No	No	No

Reported Non-Derivative Transactions

Show Other Fields >>

Sec. Name	Acquisiton - Disposition	Date	Amount	Price	Remaning Holdings	Equity Swap Involved	Form Type	Code	Nature of Ownership	Explanation
Common Stock	Acquisiton	2019-05-09	871	$1.42	4,871	No	4	M	Indirect	By Spouse
Common Stock	Acquisiton	2019-05-09	1,225	$1.63	6,096	No	4	M	Indirect	By Spouse
Common Stock	Acquisiton	2019-05-09	941	$1.32	7,037	No	4	M	Indirect	By Spouse
Common Stock	Acquisiton	2019-05-09	480	$1.32	7,517	No	4	M	Indirect	By Spouse
Common Stock	Acquisiton	2019-05-09	6,228	$0.98	13,745	No	4	M	Indirect	By Spouse
Common Stock	Acquisiton	2019-05-09	1,800	$0.97	15,545	No	4	M	Indirect	By Spouse
Common Stock	Acquisiton	2019-05-09	1,800	$0.97	17,345	No	4	M	Indirect	By Spouse
Common Stock	Disposition	2019-05-09	13,345	$28.03	4,000	No	4	S	Indirect	By Spouse

Equity Swap Involved	Form Type	Code	Nature of Ownership	Explanation
No	4	M	Indirect	By Spouse
No	4	M	Indirect	By Spouse
No	4	M	Indirect	By Spouse
No	4	M	Indirect	By Spouse
No	4	M	Indirect	By Spouse
No	4	M	Indirect	By Spouse
No	4	M	Indirect	By Spouse
No	4	S	Indirect	By Spouse

Reported Derivative Transactions

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Sec. Name	Sec. Type	Acquisiton - Disposition	Date	Amount	Price	Amount - 2	Price - 2
Common Stock	Stock Options (Right to buy)	Disposition	2019-05-09	871	$0.00	871	$1.42
Common Stock	Stock Options (Right to buy)	Disposition	2019-05-09	1,225	$0.00	1,225	$1.63
Common Stock	Stock Options (Right to buy)	Disposition	2019-05-09	941	$0.00	941	$1.32
Common Stock	Stock Options (Right to buy)	Disposition	2019-05-09	480	$0.00	480	$1.32
Common Stock	Stock Options (Right to buy)	Disposition	2019-05-09	6,228	$0.00	6,228	$0.98
Common Stock	Stock Options (Right to buy)	Disposition	2019-05-09	1,800	$0.00	1,800	$0.97
Common Stock	Stock Options (Right to buy)	Disposition	2019-05-09	1,800	$0.00	1,800	$0.97

Remaning Holdings	Expiration Date	Equity Swap Involved	Transaction Form Type	Transaction Code	Nature of Ownership
1,021	2027-08-25	No	4	M	Indirect
2,975	2028-03-30	No	4	M	Indirect
929	2027-05-22	No	4	M	Indirect
560	2027-07-05	No	4	M	Indirect
1,244	2026-01-15	No	4	M	Indirect
0	2024-06-29	No	4	M	Indirect
0	2025-04-01	No	4	M	Indirect

Reported Non-Derivative Holdings

Sec. Name	Remaning Holdings	Nature of Ownership	Explanation
Common Stock	220,627	Direct

Footnotes

The price in column 4 is a weighted average price. These shares were sold in multiple transactions ranging from $27.91 to $28.17, inclusive. The reporting person undertakes to provide Axonics Modulation Technologies, Inc., any security holder of Axonics Modulation Technologies, Inc. or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth in this footnote.
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.
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, 2017 and the remainder vesting at a rate of 1/36th per month commencing upon the one-year anniversary of July 5, 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 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.
he 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.
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.