SEC Form 4 · accession 0000899243-17-000113

UNIVERSAL BIOSENSORS INC · UBI

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Alastair Hodges

Officer — Chief Scientist

Period of report

Dec 29, 2016

Accepted (ET)

Jan 3, 2017 · 6:47 pm EST

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001279695

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Restricted Shares of Common Stock^F12	Dec 29, 2016	A	3,030	$0.00	A	2,846,615	D

Table II — derivative securities

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Stock Option (Right to Buy)^F2	$0.00	holding	—	—	—	—	Jan 29, 2022	Common Stock	40,000	40,000	D
Stock Option (Right to Buy^F3	$0.00	holding	—	—	—	—	Dec 11, 2020	Common Stock	40,000	40,000	D
Stock Option (Right to Buy)^F4	$0.00	holding	—	—	—	—	Nov 12, 2019	Common Stock	25,000	25,000	D
Stock Option (Right to Buy)^F5	$0.00	holding	—	—	—	—	Nov 17, 2018	Common Stock	25,000	25,000	D
Stock Option (Right to Buy)^F6	$0.00	holding	—	—	—	—	Nov 10, 2017	Common Stock	25,000	25,000	D
Stock Option (Right to Buy)^F1,F7	$1.72	holding	—	—	—	—	Nov 9, 2019	Common Stock	100,000	100,000	D
Stock Option (Right to Buy)^F8	$0.00	holding	—	—	—	—	Jun 28, 2019	Common Stock	105,000	105,000	D
Stock Option (Right to Buy)^F9	$0.00	holding	—	—	—	—	May 14, 2019	Common Stock	16,667	16,667	D
Stock Option (Right to Buy)^F1,F10	$0.89	holding	—	—	—	—	Mar 16, 2018	Common Stock	100,000	100,000	D
Stock Option (Right to Buy)^F1,F11	$1.18	holding	—	—	—	—	Mar 22, 2017	Common Stock	36,000	36,000	D

Explanation of responses

F1The issue price reported is stated in Australian dollars.
F101/3 of the stock options vested and became exercisable on 12/31/2008. 1/3 of the stock options vested and became exercisable on 12/31/2009. The remaining stock options vested and became exercisable on 12/31/2010
F11The stock options vested and became exercisable in three equal tranches on 12/31/2007, 12/31/2008, and 12/31/2009.
F12Includes (i) 2,834,698 shares in the form of CDIs Dr. Hodges holds directly and (ii) 8,887 restricted fully paid shares.
F213,333 stock options vested and became exercisable on 12/31/2015, 13,333 stock options vest and become exercisable on 12/31/2016, and 13,334 stock options vest and become exercisable on 12/31/2017.
F313,333 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 vest and become exercisable on 12/31/2016.
F48,333 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 vest and become exercisable on 12/31/2015.
F58,333 stock options vested and became exercisable on 12/31/2012, 8,333 stock options vested and became exercisable on 12/31/2013, and 8,334 stock options vested and became exercisable on 12/31/2014.
F68,333 stock options vested and became exercisable on 12/31/2011, 8,333 stock options vested and became exercisable on 12/31/2012, and 8,334 stock options vested and became exercisable on 12/31/2013
F71/3 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.
F810,000 stock options vested and became exercisable on 12/31/2010, 21,666 stock options vested and became exercisable on 12/31/2011, 35,000 stock options vested and became exercisable on 12/31/2012, 25,000 stock options vest and become exercisable on 12/31/2013, and 13,334 stock options vest and become exercisable on 12/31/2014.
F98,333 stock options vested and became exercisable on 12/31/2009 and were exercised on February 10, 2010. 8,333 stock options vested and became exercisable on 12/31/2010 and the remaining stock options vested and became exercisable on 12/31/11