4//SEC Filing
NeoMed Innovation V Ltd 4
Accession 0000899243-18-028110
CIK 0001603756other
Filed
Nov 1, 8:00 PM ET
Accepted
Nov 2, 7:51 PM ET
Size
23.8 KB
Accession
0000899243-18-028110
Insider Transaction Report
Form 4
NeoMed Innovation V L.P.
10% Owner
Transactions
- Conversion
Common Stock
2018-11-02+243,750→ 1,151,098 total(indirect: By NeoMed Innovation V, L.P.) - Conversion
Series A Preferred Stock
2018-11-02−195,000→ 0 total(indirect: By NeoMed Innovation V, L.P.)→ Common Stock (451,738 underlying) - Conversion
Series B-2 Preferred Stock
2018-11-02−203,125→ 0 total(indirect: By NeoMed Innovation V, L.P.)→ Common Stock (243,750 underlying) - Conversion
Series C Preferred Stock
2018-11-02−308,155→ 0 total(indirect: By NeoMed Innovation V, L.P.)→ Common Stock (369,786 underlying) - Conversion
Common Stock
2018-11-02+451,738→ 451,738 total(indirect: By NeoMed Innovation V, L.P.) - Conversion
Common Stock
2018-11-02+369,786→ 1,520,884 total(indirect: By NeoMed Innovation V, L.P.) - Conversion
Common Stock
2018-11-02+455,610→ 907,348 total(indirect: By NeoMed Innovation V, L.P.) - Conversion
Series B-1 Preferred Stock
2018-11-02−379,675→ 0 total(indirect: By NeoMed Innovation V, L.P.)→ Common Stock (455,610 underlying)
NeoMed Innovation V Ltd
10% Owner
Transactions
- Conversion
Common Stock
2018-11-02+451,738→ 451,738 total(indirect: By NeoMed Innovation V, L.P.) - Conversion
Common Stock
2018-11-02+243,750→ 1,151,098 total(indirect: By NeoMed Innovation V, L.P.) - Conversion
Series A Preferred Stock
2018-11-02−195,000→ 0 total(indirect: By NeoMed Innovation V, L.P.)→ Common Stock (451,738 underlying) - Conversion
Series B-2 Preferred Stock
2018-11-02−203,125→ 0 total(indirect: By NeoMed Innovation V, L.P.)→ Common Stock (243,750 underlying) - Conversion
Common Stock
2018-11-02+455,610→ 907,348 total(indirect: By NeoMed Innovation V, L.P.) - Conversion
Common Stock
2018-11-02+369,786→ 1,520,884 total(indirect: By NeoMed Innovation V, L.P.) - Conversion
Series B-1 Preferred Stock
2018-11-02−379,675→ 0 total(indirect: By NeoMed Innovation V, L.P.)→ Common Stock (455,610 underlying) - Conversion
Series C Preferred Stock
2018-11-02−308,155→ 0 total(indirect: By NeoMed Innovation V, L.P.)→ Common Stock (369,786 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]The shares are held of record by NeoMed Innovation V, L.P. ("NeoMed"). NeoMed Innovation V Limited is the general partner of NeoMed and has voting and dispositive power over the shares held by NeoMed. Erik Amble, Ph.D., who is a member of the Issuer's board of directors, is a director of NeoMed Innovation V Limited, and may be deemed to have voting and dispositive power over the shares held by NeoMed. Mr. Amble disclaims beneficial ownership of these securities and this report shall not be deemed an admission that Mr. Amble is the beneficial owner of such securities for purposes of Section 16 or for any other purpose, except to the extent of his respective pecuniary interest therein.
- [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
IncorporatedJersey
Related Parties
1- filerCIK 0001722666
Filing Metadata
- Form type
- 4
- Filed
- Nov 1, 8:00 PM ET
- Accepted
- Nov 2, 7:51 PM ET
- Size
- 23.8 KB