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Filing Details

Issuer

Cik	Name	Symbol	Sector (SIC)	IRS No
1603756	Axonics Modulation Technologies Inc.	AXNX	Surgical & Medical Instruments & Apparatus (3841)	454744083

Insiders

Cik	Name	Reported Address	Insider Title	Director	Officer	Large Shareholder	Other
1756338	Geoff Pardo	26 Technology Drive Irvine CA 92618		Yes	No	Yes	No

Reported Non-Derivative Transactions

Sec. Name	Acquisiton - Disposition	Date	Amount	Price	Remaning Holdings	Equity Swap Involved	Form Type	Code	Nature of Ownership	Explanation
Common Stock	Acquisiton	2018-11-02	2,266,666	$0.00	2,266,666	No	4	C	Indirect	By CooperatieveGilde Healthcare IVU.A.
Common Stock	Acquisiton	2018-11-02	866,666	$15.00	3,133,332	No	4	P	Indirect	By CooperatieveGilde Healthcare IVU.A.

Equity Swap Involved	Form Type	Code	Nature of Ownership	Explanation
No	4	C	Indirect	By CooperatieveGilde Healthcare IVU.A.
No	4	P	Indirect	By CooperatieveGilde Healthcare IVU.A.

Reported Derivative Transactions

Sec. Name	Sec. Type	Acquisiton - Disposition	Date	Amount	Price	Amount - 2	Price - 2
Common Stock	Series C Preferred Stock	Disposition	2018-11-02	1,888,888	$0.00	2,266,666	$0.00

Remaning Holdings	Exercise Date	Expiration Date	Equity Swap Involved	Transaction Form Type	Transaction Code	Nature of Ownership
0			No	4	C	Indirect

Footnotes

Reflects a 1.2-for-1 forward stock split of the Issuer's common stock effected on October 18, 2018.
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 Series C preferred stock had no expiration date.
The shares are held directly by Cooperatieve Gilde Healthcare IV U.A. ("Gilde"). The reporting person, who is a member of the Issuer's board of directors, is a partner of Gilde. Gilde is managed by Gilde Healthcare IV Management B.V. ("Management"). Management is owned by Gilde Healthcare Holding B.V. ("Holding"). Each of the reporting person, Management and Holding may be deemed to have voting, investment and dispositive power with respect to these securities. Each of the reporting person, Management and Holding disclaims beneficial ownership of these securities and this report shall not be deemed an admission that any of them is the beneficial owner of such securities for purposes of Section 16 or for any other purpose, except to the extent of their respective pecuniary interests therein.