4//SEC Filing
Wisniewski Raphael 4
Accession 0000899243-18-028094
CIK 0001603756other
Filed
Nov 1, 8:00 PM ET
Accepted
Nov 2, 7:35 PM ET
Size
23.7 KB
Accession
0000899243-18-028094
Insider Transaction Report
Form 4
Wisniewski Raphael
Director10% Owner
Transactions
- Conversion
Common Stock
2018-11-02+806,080→ 1,605,308 total(indirect: See footnote) - Conversion
Series B-2 Preferred Stock
2018-11-02−359,375→ 0 total(indirect: See footnote)→ Common Stock (431,250 underlying) - Purchase
Common Stock
2018-11-02$15.00/sh+866,666$12,999,990→ 3,557,461 total(indirect: See footnote) - Conversion
Series B-1 Preferred Stock
2018-11-02−671,733→ 0 total(indirect: See footnote)→ Common Stock (806,080 underlying) - Conversion
Series C Preferred Stock
2018-11-02−545,197→ 0 total(indirect: See footnote)→ Common Stock (654,237 underlying) - Conversion
Common Stock
2018-11-02+799,228→ 799,228 total(indirect: See footnote) - Conversion
Common Stock
2018-11-02+431,250→ 2,036,558 total(indirect: See footnote) - Conversion
Common Stock
2018-11-02+654,237→ 2,690,795 total(indirect: See footnote) - Conversion
Series A Preferred Stock
2018-11-02−345,000→ 0 total(indirect: See footnote)→ Common Stock (799,228 underlying)
Footnotes (6)
- [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]2,824,128 shares are held of record by BioDiscovery 4 FCPR ("BioDiscovery") and 733,333 shares are held of record by BioDiscovery 5 ("BioDiscovery 5"). Andera Partners ("Andera") is the manager of BioDiscovery and BioDiscovery 5 and may be deemed to have sole voting and dispositive power over the shares held by BioDiscovery and BioDiscovery 5. The reporting person is a director of the Issuer and is a partner of Andera, and may be deemed to share voting and dispositive power over the shares held by BioDiscovery and BioDiscovery 5. The reporting person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares 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.
- [F5]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-2 preferred stock automatically converted into 1.2 shares of the Issuer's common stock. The B-2 preferred stock had no expiration date.
- [F6]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 C preferred stock automatically converted into 1.2 shares of the Issuer's common stock. The C preferred stock had no expiration date.
Documents
Issuer
Axonics Modulation Technologies, Inc.
CIK 0001603756
Entity typeother
Related Parties
1- filerCIK 0001578307
Filing Metadata
- Form type
- 4
- Filed
- Nov 1, 8:00 PM ET
- Accepted
- Nov 2, 7:35 PM ET
- Size
- 23.7 KB