SEC Form 4 · accession 0001209191-16-118977
BIOLASE, INC · BIOL
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jonathan T Lord M.D.
Director
Period of report
May 6, 2016
Accepted (ET)
May 10, 2016 · 9:50 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (right to buy)F1 | $1.41 | May 6, 2016 | A | 120,152 | A | — | May 6, 2026 | Common Stock | 120,152 | 293,739 | D |
| Restricted Stock UnitF2,F3 | — | May 6, 2016 | A | 50,000 | A | — | — | Common Stock | 50,000 | 50,000 | D |
Explanation of responses
- F1The stock option vests and is exercisable in equal monthly installments over a consecutive 12-month period, commencing one month from the date of grant.
- F2Each restricted stock unit represents the right to receive, at settlement, one share of common stock.
- F3The restricted stock unit award fully vests and is immediately exercisable on the first anniversary of the date of the award.