Statement of Changes in Beneficial Ownership (4)
September 03 2021 - 6:53PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
Woock John |
2. Issuer Name and Ticker or Trading Symbol
Axonics, Inc.
[
AXNX
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) Chief Marketing Officer |
(Last)
(First)
(Middle)
26 TECHNOLOGY DRIVE |
3. Date of Earliest Transaction
(MM/DD/YYYY)
9/1/2021 |
(Street)
IRVINE, CA 92618
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock | 9/1/2021 | | M | | 5000.00 | A | $1.63 | 34932.00 | D | |
Common Stock | 9/1/2021 | | S(1) | | 8443.00 | D | $74.7264 (2) | 26489.00 | D | |
Common Stock | 9/2/2021 | | S(1) | | 1557.00 | D | $75.5793 (3) | 24932.00 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Stock Option (Right to Buy) | $1.63 | 9/1/2021 | | M | | | 3443.00 | (4) | 3/30/2028 | Common Stock | 3443.00 | $0.00 | 12757.00 | D | |
Stock Option (Right to Buy) | $1.63 | 9/2/2021 | | M | | | 1557.00 | (4) | 3/30/2028 | Common Stock | 1557.00 | $0.00 | 11200.00 | D | |
Explanation of Responses: |
(1) | This sale was pursuant to a 10b5-1 plan adopted by the reporting person on June 15, 2021. |
(2) | This transaction was executed in multiple trades at prices ranging from $73.82 to $75.27. The price reported above reflects the weighted average price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected. |
(3) | This transaction was executed in multiple trades at prices ranging from $75.00 to $76.27. The price reported above reflects the weighted average price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected. |
(4) | The shares subject to the option vest over a period of four years. 7,800 of the shares subject to the option vested on March 30, 2018 and the remainder vest at a rate of 1/36th per month commencing on March 30, 2019, provided the reporting person remains in continuous service on each vesting date, subject to accelerated vesting in certain events, including upon certain changes of control of the Issuer. The option is subject to an early exercise provision and is immediately exercisable. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Woock John 26 TECHNOLOGY DRIVE IRVINE, CA 92618 |
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| Chief Marketing Officer |
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Signatures
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/s/ Dan Dearen, as Attorney-in-Fact for John Woock, Ph.D | | 9/3/2021 |
**Signature of Reporting Person | Date |
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