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3//SEC Filing

Alfred E. Mann Foundation for Scientific Research 3

Accession 0000899243-18-027728

CIK 0001603756other

Filed

Oct 29, 8:00 PM ET

Accepted

Oct 30, 9:19 PM ET

Size

11.1 KB

Accession

0000899243-18-027728

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.

Issuer

Axonics Modulation Technologies, Inc.

CIK 0001603756

Entity typeother
IncorporatedCA

Related Parties

1
  • filerCIK 0001756303

Filing Metadata

Form type
3
Filed
Oct 29, 8:00 PM ET
Accepted
Oct 30, 9:19 PM ET
Size
11.1 KB