0001209191-18-029962.txt : 20180514
0001209191-18-029962.hdr.sgml : 20180514
20180514174925
ACCESSION NUMBER: 0001209191-18-029962
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180511
FILED AS OF DATE: 20180514
DATE AS OF CHANGE: 20180514
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: LORD JONATHAN T MD
CENTRAL INDEX KEY: 0001112980
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36385
FILM NUMBER: 18832190
MAIL ADDRESS:
STREET 1: 500 WEST MAIN ST.
CITY: LOUISVILLE
STATE: KY
ZIP: 40202
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: BIOLASE, INC
CENTRAL INDEX KEY: 0000811240
STANDARD INDUSTRIAL CLASSIFICATION: DENTAL EQUIPMENT & SUPPLIES [3843]
IRS NUMBER: 870442441
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 4 CROMWELL
CITY: IRVINE
STATE: CA
ZIP: 92618
BUSINESS PHONE: 949-361-1200
MAIL ADDRESS:
STREET 1: 4 CROMWELL
CITY: IRVINE
STATE: CA
ZIP: 92618
FORMER COMPANY:
FORMER CONFORMED NAME: BIOLASE TECHNOLOGY INC
DATE OF NAME CHANGE: 19941117
FORMER COMPANY:
FORMER CONFORMED NAME: LASER MEDICAL TECHNOLOGY INC
DATE OF NAME CHANGE: 19941117
FORMER COMPANY:
FORMER CONFORMED NAME: LASER ENDO TECHNIC CORP
DATE OF NAME CHANGE: 19920708
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2018-05-11
0
0000811240
BIOLASE, INC
BIOL
0001112980
LORD JONATHAN T MD
4 CROMWELL
IRVINE
CA
92618
1
0
0
0
Common Stock
2018-05-11
4
M
0
7042
A
100470
D
Restricted Stock Unit
2018-05-11
4
M
0
7042
0.00
D
Common Stock
7042
0
D
Restricted Stock Unit
2018-05-14
4
A
0
27312
0.00
A
Common Stock
27312
27312
D
Restricted Stock Unit
2018-05-14
4
A
0
144828
0.00
A
Common Stock
144828
172140
D
Each restricted stock unit represents the right to receive, at settlement, one share of common stock.
On May 10, 2017, the reporting person was granted 35,211 restricted stock units, which vested on May 11, 2018. On May 10, 2018, the Company issued a press release announcing that, at the Annual Meeting, the Company's stockholders approved a proposal to amend the Company's Restated Certificate of Incorporation to effect a reverse stock split of Company common stock at a ratio of not less than 1-for-5 and not more than 1-for-15, with the final ratio to be determined by the Board. Immediately after the Annual Meeting, the Board approved the reverse stock split at a ratio of one post-split share for every five pre-split shares.
The restricted stock units vest as follows: (i) two-fifths of the restricted stock units vest on December 31, 2018, and (ii) three-fifths of the restricted
stock units vest on December 31, 2019.
The restricted stock unit award fully vests and is immediately exercisable on the first anniversary of the date of the award.
/s/ Michael C. Carroll, attorney-in-fact for Jonathan T. Lord
2018-05-14