-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, LruVq9PBFNv+/UcHzGzql/p/7eUfU2abnzGyFJyQ6dz6DQSnuWKp4O38JhafkaMa 0PROKQ/2T2BtfgBrKCtNMQ== 0001179110-04-013913.txt : 20040629 0001179110-04-013913.hdr.sgml : 20040629 20040629191221 ACCESSION NUMBER: 0001179110-04-013913 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040625 FILED AS OF DATE: 20040629 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Kenneth Czaja CENTRAL INDEX KEY: 0001292495 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11064 FILM NUMBER: 04889720 BUSINESS ADDRESS: BUSINESS PHONE: 925-979-2646 MAIL ADDRESS: STREET 1: 490 NORTH WIGET LANE CITY: WALNUT CREEK STATE: CA ZIP: 94598 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BRITESMILE INC CENTRAL INDEX KEY: 0000866734 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-HEALTH SERVICES [8000] IRS NUMBER: 870410364 STATE OF INCORPORATION: UT FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 490 NORTH WIGET LANE CITY: WALNUT CREEK STATE: CA ZIP: 94598 BUSINESS PHONE: 9259416260 MAIL ADDRESS: STREET 1: 490 NORTH WIGET LANE CITY: WALNUT CREEK STATE: CA ZIP: 94598 FORMER COMPANY: FORMER CONFORMED NAME: ION LASER TECHNOLOGY INC DATE OF NAME CHANGE: 19930328 4 1 edgar.xml FORM 4 - X0202 4 2004-06-25 0 0000866734 BRITESMILE INC BSML 0001292495 Kenneth Czaja 490 NORTH WIGET LANE WALNUT CREEK CA 94598 0 1 0 0 Chief Financial Officer options to acquire common stock 10.50 2004-06-25 4 A 0 15000 0 A 2004-06-25 2014-06-25 common stock 15000 75000 D options to acquire common stock 10.50 2004-06-25 4 A 0 15000 0 A 2005-05-24 2014-06-25 common stock 15000 75000 D options to acquire common stock 10.50 2004-06-25 4 A 0 15000 0 A 2006-05-24 2014-06-25 common stock 15000 75000 D options to acquire common stock 10.50 2004-06-25 4 A 0 15000 0 A 2007-05-24 2014-06-25 common stock 15000 75000 D options to acquire common stock 10.50 2004-06-25 4 A 0 15000 0 A 2008-05-24 2014-06-25 common stock 15000 75000 D Kenneth Czaja 2004-06-29 -----END PRIVACY-ENHANCED MESSAGE-----