0000899243-19-019391.txt : 20190709 0000899243-19-019391.hdr.sgml : 20190709 20190709175423 ACCESSION NUMBER: 0000899243-19-019391 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190529 FILED AS OF DATE: 20190709 DATE AS OF CHANGE: 20190709 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Balak Salesh CENTRAL INDEX KEY: 0001397500 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-52607 FILM NUMBER: 19947903 MAIL ADDRESS: STREET 1: 103 RICKETTS ROAD STREET 2: MT. WAVERLEY CITY: VICTORIA STATE: C3 ZIP: 3149 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: UNIVERSAL BIOSENSORS INC CENTRAL INDEX KEY: 0001279695 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 980424072 STATE OF INCORPORATION: DE BUSINESS ADDRESS: STREET 1: 1 CORPORATE AVENUE STREET 2: ROWVILLE CITY: VICTORIA STATE: C3 ZIP: 3178 BUSINESS PHONE: 613-9213-9000 MAIL ADDRESS: STREET 1: 1 CORPORATE AVENUE STREET 2: ROWVILLE CITY: VICTORIA STATE: C3 ZIP: 3178 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2019-05-29 0 0001279695 UNIVERSAL BIOSENSORS INC UBI 0001397500 Balak Salesh 1 CORPORATE AVENUE ROWVILLE VICTORIA C3 3178 AUSTRALIA 0 1 0 0 Chief Financial Officer Common Stock 2019-05-29 4 M 0 73334 0.00 A 201558 D Stock Option (Right to Buy) 0.50 2023-04-20 Common Stock 721000 721000 D Stock Option (Right to Buy) 0.50 2024-02-27 Common Stock 216300 216300 D Stock Option (Right to Buy) 0.00 2022-01-29 Common Stock 40000 40000 D Stock Option (Right to Buy) 0.00 2020-12-11 Common Stock 40000 40000 D Stock Option (Right to Buy) 0.00 2019-11-12 Common Stock 25000 25000 D Stock Option (Right to Buy) 1.72 2019-11-09 Common Stock 100000 100000 D Stock Option (Right to Buy) 0.00 2019-05-29 4 M 0 73334 0.00 D 2019-06-28 Common Stock 73334 0 D The price reported is stated in Australian dollars. 13,333 stock options vested and became exercisable on 12/31/2015, 13,333 stock options vested and became exercisable on 12/31/2016, and 13,334 stock options vest and become exercisable on 12/31/2017. 13,333 stock options vested and became exercisable on 12/31/2014, 13,333 stock options vested and became exercisable on 12/31/2015, and 13,334 stock options vested and became exercisable on 12/31/2016. 8,333 stock options vested and became exercisable on 12/31/2013, 8,333 stock options vested and became exercisable on 12/31/2014, and 8,334 stock options vested and became exercisable on 12/31/2015. 1/3 of the stock options vested and became exercisable on 12/31/2010, 1/3 of the stock options vested and became exercisable on 12/31/2011 and the remaining stock options vested and became exercisable on 12/31/2012. 10,000 stock options vested and became exercisable on 12/31/2010 and were exercised on 11/10/2011. 21,666 stock options vested and became exercisable on 12/31/11 and were exercised on 08/27/2012, 35,000 stock options vested and became exercisable on 12/31/2012, 25,000 stock options vested and became exercisable on 12/31/2013, and 13,334 stock options vested and became exercisable on 12/31/2014. The remaining options were all exercised on 05/29/2019. 206,000 of the stock options vested and became exercisable on 10/05/2016, 412,000 of the stock options vested and became exercisable on 12/31/2016 and 103,000 of the stock options vested and became exercisable on 02/23/2017. 216,300 stock options vested and became exercisable on December 31, 2017. Includes (i) 194,362 shares in the form of CDIs Mr. Balak holds directly and (ii) 7,196 restricted fully paid shares. /s/ Salesh Balak 2019-07-08