SEC Form 4 · accession 0001140361-15-045045

BIOLASE, INC · BIOL

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

Reporting owners

10% Owner

10% Owner

Period of report

Nov 24, 2015

Accepted (ET)

Dec 18, 2015 · 11:30 am EST

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 Stock^F2,F1	Nov 24, 2015	P	100	$0.92	A	5,885,703	I	By Trust
Common Stock^F2,F1	Nov 25, 2015	P	44,200	$0.90	A	5,929,903	I	By Trust
Common Stock^F2,F1	Nov 26, 2015	P	2,045	$0.89	A	5,931,948	I	By Trust
Common Stock^F2,F1	Nov 30, 2015	P	16,752	$0.90	A	5,948,700	I	By Trust
Common Stock^F2,F1	Dec 2, 2015	P	5,900	$0.85	A	5,954,600	I	By Trust
Common Stock^F2,F1	Dec 3, 2015	P	16,427	$0.81	A	5,971,027	I	By Trust
Common Stock^F2,F1	Dec 4, 2015	P	5,286	$0.81	A	5,976,313	I	By Trust
Common Stock^F2,F1	Dec 7, 2015	P	8,561	$0.80	A	5,984,874	I	By Trust
Common Stock^F2,F1	Dec 8, 2015	P	14,596	$0.79	A	5,999,470	I	By Trust
Common Stock^F2,F1	Dec 9, 2015	P	5,704	$0.79	A	6,005,174	I	By Trust
Common Stock^F2,F1	Dec 10, 2015	P	31,699	$0.78	A	6,036,873	I	By Trust
Common Stock^F2,F1	Dec 11, 2015	P	7,078	$0.77	A	6,043,951	I	By Trust
Common Stock^F2,F1	Dec 14, 2015	P	42,923	$0.74	A	6,086,874	I	By Trust
Common Stock^F2,F1	Dec 15, 2015	P	28,000	$0.72	A	6,114,874	I	By Trust
Common Stock	holding	—	—		—	14,800	I	By spouse

No Table II lines on this filing.

F1These shares are held by the Jack W. Schuler Living Trust (the "Trust"). Mr. Schuler serves as sole trustee to the Trust.
F2The price reported in Column 4 is a weighted average price. These shares 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.