SEC Form 4 · accession 0001209191-17-052621
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
Sep 11, 2017
Accepted (ET)
Sep 13, 2017 · 4:37 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 | $0.54 | Sep 11, 2017 | A | 65,385 | A | — | Sep 11, 2027 | Common Stock | 65,385 | 492,503 | D |
| Stock Option (right to buy)F1 | $0.61 | Sep 12, 2017 | A | 65,891 | A | — | Sep 12, 2027 | Common Stock | 65,891 | 558,394 | D |
Explanation of responses
- F1The stock option vests and is exercisable in equal monthly installments over a consecutive 8-month period, commencing October 10, 2017.