SEC Form 4/A · accession 0000905148-16-001934
BIOLASE, INC · BIOL
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 4/A). It replaces an earlier filing for the same period.
Period of report
Oct 21, 2015
Accepted (ET)
Oct 7, 2016 · 12:51 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000811240
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2,F3 | Oct 21, 2015 | P | 33,762 | $0.95 | A | 4,213,429 | I | By Trust |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1These shares of Common Stock were inadvertently omitted from the reporting person's Form 4 filed December 18, 2015, and also were omitted from the reporting person's total amount of securities beneficially owned as reported in subsequent Forms 4, until corrected in the Form 4 filed October 4, 2016.
- F2The price reported in Column 4 is a weighted average price. These shares of Common Stock were purchased in multiple transactions at prices within a $1.00 range. The reporting person undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares purchased at each separate price for each transaction reported in this Form 4.
- F3These shares of Common Stock are held directly by the Jack W. Schuler Living Trust (the "Trust"). Mr. Schuler serves as sole trustee to the Trust.