0001437749-22-004498.txt : 20220228 0001437749-22-004498.hdr.sgml : 20220228 20220228060910 ACCESSION NUMBER: 0001437749-22-004498 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220224 FILED AS OF DATE: 20220228 DATE AS OF CHANGE: 20220228 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: 22683767 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 rdgdoc.xml FORM 4 X0306 4 2022-02-24 0001279695 UNIVERSAL BIOSENSORS INC UBI 0001397500 Balak Salesh 1 CORPORATE AVENUE ROWVILLE VICTORIA C3 3178 AUSTRALIA 1 Chief Financial Officer Common Stock 2022-02-24 4 A 0 30000 0 A 336558 D Performance Rights 2025-03-24 Common Stock 500000 500000 D Performance Rights 2025-03-24 Common Stock 250000 250000 D Stock Options (Right to Buy) 0.3000 2025-03-24 Common Stock 500000 500000 D Stock Options (Right to Buy) 0.5000 2023-04-20 Common Stock 721000 721000 D Stock Options (Right to Buy) 0.5000 2024-02-27 Common Stock 216300 216300 D The price reported is stated in Australian dollars. The options are fully vested and became exercisable on 03/01/2021. 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. Each performance right represents a contingent right to receive one share of common stock of Universal Biosensors, Inc. ("UBI"). The performance rights vest upon, among other triggers, UBI's market capitalization having achieved a specified threshold. Each performance right represents a contingent right to receive one share of common stock of UBI. The performance rights vest upon a change of control transaction with a value greater a specified threshold. /s/ Salesh Balak 2022-02-24