0000899243-17-008687.txt : 20170327
0000899243-17-008687.hdr.sgml : 20170327
20170327181419
ACCESSION NUMBER: 0000899243-17-008687
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20161005
FILED AS OF DATE: 20170327
DATE AS OF CHANGE: 20170327
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: UNIVERSAL BIOSENSORS INC
CENTRAL INDEX KEY: 0001279695
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 980424072
STATE OF INCORPORATION: DE
BUSINESS ADDRESS:
STREET 1: 1 CORPORATE AVENUE
STREET 2: ROWVILLE
CITY: VICTORIA
STATE: C3
ZIP: 3178
BUSINESS PHONE: 613-9213-9000
MAIL ADDRESS:
STREET 1: 1 CORPORATE AVENUE
STREET 2: ROWVILLE
CITY: VICTORIA
STATE: C3
ZIP: 3178
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Balak Salesh
CENTRAL INDEX KEY: 0001397500
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-52607
FILM NUMBER: 17716382
MAIL ADDRESS:
STREET 1: 103 RICKETTS ROAD
STREET 2: MT. WAVERLEY
CITY: VICTORIA
STATE: C3
ZIP: 3149
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2016-10-05
0
0001279695
UNIVERSAL BIOSENSORS INC
UBI
0001397500
Balak Salesh
1 CORPORATE AVENUE
ROWVILLE
VICTORIA
C3
3178
AUSTRALIA
0
1
0
0
Chief Financial Officer
Restricted Shares of Common Stock
2016-12-28
4
A
0
3030
0.00
A
82391
D
Stock Option (Right to Buy)
0.50
2023-04-20
Common Stock
721000
742000
D
Stock Option (Right to Buy)
0.00
2022-01-29
Common Stock
40000
40000
D
Stock Option (Right to Buy)
0.00
2020-12-11
Common Stock
40000
40000
D
Stock Option (Right to Buy)
0.00
2019-11-12
Common Stock
25000
25000
D
Stock Option (Right to Buy)
0.00
2018-11-17
Common Stock
25000
25000
D
Stock Option (Right to Buy)
0.00
2017-11-10
Common Stock
16667
16667
D
Stock Option (Right to Buy)
1.72
2019-11-09
Common Stock
100000
100000
D
Stock Option (Right to Buy)
0.00
2019-06-28
Common Stock
73334
73334
D
Stock Option (Right to Buy)
0.89
2018-03-16
Common Stock
100000
100000
D
The price reported is stated in Australian dollars.
13,333 stock options vested and became exercisable on 12/31/2015, 13,333 stock options vested and became exercisable on 12/31/2016, and 13,334 stock options vest and become exercisable on 12/31/2017.
13,333 stock options vested and became exercisable on 12/31/2014, 13,333 stock options vested and became exercisable on 12/31/2015, and 13,334 stock options vested and became exercisable on 12/31/2016.
8,333 stock options vested and became exercisable on 12/31/2013, 8,333 stock options vested and became exercisable on 12/31/2014, and 8,334 stock options vested and became exercisable on 12/31/2015.
8,333 stock options vested and became exercisable on 12/31/2012, 8,333 stock options vested and became exercisable on 12/31/2013, and 8,333 stock options vested and became exercisable on 12/31/2014.
8,333 stock options vested and became exercisable on 12/31/2011 and were exercised on August 27 2012, 8,333 stock options vested and became exercisable on 12/31/2012, and 8,334 stock options vested and became exercisable on 12/31/2013.
1/3 of the stock options vested and became exercisable on 12/31/2010, 1/3 of the stock options vested and became exercisable on 12/31/2011 and the remaining stock options vested and became exercisable on 12/31/2012.
10,000 stock options vested and became exercisable on 12/31/2010 and were exercised on 11/10/2011. 21,666 stock options vested and became exercisable on 12/31/11 and were exercised on 08/27/2012, 35,000 stock options vested and became exercisable on 12/31/2012, 25,000 stock options vested and became exercisable on 12/31/2013, and 13,334 stock options vested and became exercisable on 12/31/2014.
1/3 of the stock options vested and became exercisable on 12/31/2008, 1/3 of the stock options vested and became exercisable on 12/31/2009; and the remaining stock options vested and became exercisable on 12/31/2010.
206,000 of the stock options vested and became exercisable on October 5, 2016, 412,000 of the stock options vested and became exerciseable on December 31, 2016 and 103,000 of the stock options vested and became exercisable on February 23, 2017.
Includes (i) 72,514 shares in the form of CDIs Mr. Balak holds directly and (ii) 9,877 restricted fully paid shares.
/s/ Cameron Billingsley, Attorney-in-Fact
2017-03-27