4//SEC Filing
Petrovich John George 4
Accession 0000899243-18-028086
CIK 0001603756other
Filed
Nov 1, 8:00 PM ET
Accepted
Nov 2, 7:32 PM ET
Size
12.5 KB
Accession
0000899243-18-028086
Insider Transaction Report
Form 4
Petrovich John George
Director10% Owner
Transactions
- Conversion
Series B-1 Preferred Stock
2018-11-02−771,161→ 0 total(indirect: See footnote)→ Common Stock (925,394 underlying) - Conversion
Series A Preferred Stock
2018-11-02−125,000→ 0 total(indirect: See footnote)→ Common Stock (289,576 underlying) - Conversion
Common Stock
2018-11-02+289,576→ 1,177,576 total(indirect: See footnote) - Conversion
Common Stock
2018-11-02+925,394→ 2,102,970 total(indirect: See footnote)
Footnotes (4)
- [F1]Reflects a 1.2-for-1 forward stock split of the Issuer's common stock effected on October 18, 2018.
- [F2]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 Series A preferred stock automatically converted into 2.31660 shares of the Issuer's common stock. The A preferred stock had no expiration date.
- [F3]These securities are held by The Alfred E. Mann Foundation for Scientific Research. The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of the securities for purposes of Section 16 or for any other purpose.
- [F4]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 Series B-1 preferred stock automatically converted into 1.2 shares of the Issuer's common stock. The B-1 preferred stock had no expiration date.
Documents
Issuer
Axonics Modulation Technologies, Inc.
CIK 0001603756
Entity typeother
Related Parties
1- filerCIK 0001387382
Filing Metadata
- Form type
- 4
- Filed
- Nov 1, 8:00 PM ET
- Accepted
- Nov 2, 7:32 PM ET
- Size
- 12.5 KB