SEC Form 4 · accession 0001209191-18-029962

BIOLASE, INC · BIOL

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

Reporting owner

Director

Period of report

May 11, 2018

Accepted (ET)

May 14, 2018 · 5:49 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 Stock^F1	May 11, 2018	M	7,042	—	A	100,470	D

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Restricted Stock Unit^F1,F2	—	May 11, 2018	M	7,042	D	—	—	Common Stock	7,042	0	D
Restricted Stock Unit^F1,F3	—	May 14, 2018	A	27,312	A	—	—	Common Stock	27,312	27,312	D
Restricted Stock Unit^F1,F4	—	May 14, 2018	A	144,828	A	—	—	Common Stock	144,828	172,140	D

F1Each restricted stock unit represents the right to receive, at settlement, one share of common stock.
F2On May 10, 2017, the reporting person was granted 35,211 restricted stock units, which vested on May 11, 2018. On May 10, 2018, the Company issued a press release announcing that, at the Annual Meeting, the Company's stockholders approved a proposal to amend the Company's Restated Certificate of Incorporation to effect a reverse stock split of Company common stock at a ratio of not less than 1-for-5 and not more than 1-for-15, with the final ratio to be determined by the Board. Immediately after the Annual Meeting, the Board approved the reverse stock split at a ratio of one post-split share for every five pre-split shares.
F3The restricted stock units vest as follows: (i) two-fifths of the restricted stock units vest on December 31, 2018, and (ii) three-fifths of the restricted stock units vest on December 31, 2019.
F4The restricted stock unit award fully vests and is immediately exercisable on the first anniversary of the date of the award.