SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Oates Adrian

(Last) (First) (Middle)
1 CORPORATE AVENUE
ROWVILLE

(Street)
VICTORIA C3 3178

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
UNIVERSAL BIOSENSORS INC [ UBI ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
VP, Quality & Regulatory
3. Date of Earliest Transaction (Month/Day/Year)
02/12/2013
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 02/12/2013 S 8,333 D $7,291.38(1) 3,253 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (Right to Buy) $0.00 (2) 11/12/2019 Common Stock 25,000 25,000 D
Stock Option (Right to Buy) $0.00 (3) 11/17/2018 Common Stock 25,000 25,000 D
Stock Option (Right to Buy) $0.00 (4) 11/10/2017 Common Stock 25,000 25,000 D
Stock Option (Right to Buy) $1.72(1) (5) 11/09/2019 Common Stock 100,000 100,000 D
Stock Option (Right to Buy) $0.00 (6) 06/28/2019 Common Stock 105,000 105,000 D
Stock Option (Right to Buy) $0.00 (7) 05/14/2019 Common Stock 16,667 16,667 D
Stock Option (Right to Buy) $1.2(1) (8) 09/18/2017 Common Stock 400,000 400,000 D
Explanation of Responses:
1. The price reported is stated in Australian dollars.
2. 8,333 stock options vest and become exercisable on 12/31/2013, 8,333 stock options vest and become exercisable on 12/31/2014, and 8,334 stock options vest and become exercisable on 12/31/2015.
3. 8,333 stock options vested and became exercisable on 12/31/2012, 8,333 stock options vest and become exercisable on 12/31/2013, and 8,334 stock options vest and become exercisable on 12/31/2014.
4. 1/3 of the stock options vested and became exercisable on 12/31/10, 1/3 of the stock options vested and became exercisable on 12/31/11 and the remaining stock options vested and became exercisable on 12/31/12.
5. 1/3 of the stock options vested and became exercisable on 12/31/10, 1/3 of the stock options vested and became exercisable on 12/31/11 and the remaining stock options vested and became exercisable on 12/31/12.
6. 10,000 stock options vested and became exercisable on 12/31/10, 21,666 stock options vested and became exercisable on 12/31/11, 35,000 stock options vested and became exercisable on 12/31/12, 25,000 stock options vest and become exercisable on 12/31/13, and 13,334 stock options vest and become exercisable on 12/31/14.
7. 8,333 stock options vested and became exercisable on 12/31/2010 and the remaining stock options vested and became exercisable on 12/31/11.
8. 1/3 of the stock options vested and became exercisable on 06/30/08, 1/3 of the options vested and became exercisable on 06/30/09 and the remaining stock options vested and became exercisable on 06/30/10.
/s/ Cameron Billingsley, Attorney-in-Fact 02/13/2013
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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