0000899243-19-028060.txt : 20191125
0000899243-19-028060.hdr.sgml : 20191125
20191125153241
ACCESSION NUMBER: 0000899243-19-028060
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191112
FILED AS OF DATE: 20191125
DATE AS OF CHANGE: 20191125
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: 191245904
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
2019-11-12
0
0001279695
UNIVERSAL BIOSENSORS INC
UBI
0001397500
Balak Salesh
1 CORPORATE AVENUE
ROWVILLE
VICTORIA
C3
3178
AUSTRALIA
0
1
0
0
See Remarks
Common Stock
2019-11-12
4
M
0
25000
0.00
A
226558
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
4
M
0
25000
0.00
D
2019-11-12
Common Stock
25000
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 vested and became 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. These options were exercised on 11/12/2019.
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 12/31/2017.
Includes (i) 219,362 shares in the form of CDIs Mr. Balak holds directly and (ii) 7,196 restricted fully paid shares.
Acting Chief Executive Officer/Chief Financial Officer
/s/ Salesh Balak
2019-11-22