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