SEC Form 4 · accession 0001140361-16-075646
BIOLASE, INC · BIOL
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Period of report
Aug 8, 2016
Accepted (ET)
Aug 10, 2016 · 3:28 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000811240
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Warrants to acquire Common StockF1,F3 | $2.00 | Aug 8, 2016 | P | 850,797 | A | — | Aug 8, 2021 | Common Stock | 850,797 | 2,194,983 | I |
| Series C Preferred StockF2,F3 | $1.13 | Aug 8, 2016 | P | 37,091 | A | — | — | Common Stock | 3,709,100 | 37,091 | I |
Explanation of responses
- F1See Exhibit 99.1
- F2See Exhibit 99.1
- F3See Exhibit 99.1
Remarks
Exhibit List: Exhibit 99.1 - Explanation of Responses Exhibit 99.2 - Joint Filer Information and Signatures