Alfred E. Mann Foundation for Scientific Research 3

3 · Axonics Modulation Technologies, Inc. · Filed Oct 30, 2018

Insider Transaction Report

Form 3
Period: 2018-10-30
Holdings
  • Series A Preferred Stock

    Common Stock (289,576 underlying)
  • Series B-1 Preferred Stock

    Common Stock (925,394 underlying)
  • Common Stock

    888,000
Footnotes (3)
  • [F1]Reflects a 1.2-for-1 forward stock split of the Issuer's common stock effected on October 18, 2018.
  • [F2]Each share of Series A preferred stock is convertible, at any time, at the reporting person's election, into shares of the Issuer's common stock at the then-effective conversion rate for no additional consideration in accordance with the Issuer's Fourth Amended and Restated Certificate of Incorporation, as amended to date. In addition, effective upon the closing of the Issuer's initial public offering of its common stock under the Securities Act of 1933, as amended, each share of the Series A preferred stock will automatically convert into 2.31660 shares of the Issuer's common stock. The Series A preferred stock has no expiration date.
  • [F3]Each share of Series B-1 preferred stock is convertible, at any time, at the reporting person's election, into shares of the Issuer's common stock at the then-effective conversion rate for no additional consideration in accordance with the Issuer's Fourth Amended and Restated Certificate of Incorporation, as amended to date. In addition, effective upon the closing of the Issuer's initial public offering of its common stock under the Securities Act of 1933, as amended, each share of the Series B-1 preferred stock will automatically convert into 1.2 shares of the Issuer's common stock. The Series B-1 preferred stock has no expiration date.

Documents

2 files