0000950103-15-006644.txt : 20150820
0000950103-15-006644.hdr.sgml : 20150820
20150820142343
ACCESSION NUMBER: 0000950103-15-006644
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20150820
FILED AS OF DATE: 20150820
DATE AS OF CHANGE: 20150820
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: BIO REFERENCE LABORATORIES INC
CENTRAL INDEX KEY: 0000792641
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MEDICAL LABORATORIES [8071]
IRS NUMBER: 222405059
STATE OF INCORPORATION: NJ
FISCAL YEAR END: 1031
BUSINESS ADDRESS:
STREET 1: 481 EDWARD H ROSS DR
CITY: ELMWOOD PARK
STATE: NJ
ZIP: 07407-3118
BUSINESS PHONE: 2017912186
MAIL ADDRESS:
STREET 1: 481 EDWARD H ROSS DRIVE
CITY: ELMWOOD PARK
STATE: NJ
ZIP: 07407-3118
FORMER COMPANY:
FORMER CONFORMED NAME: MED MOBILE INC
DATE OF NAME CHANGE: 19891115
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: GRODMAN MARC
CENTRAL INDEX KEY: 0001189452
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-15266
FILM NUMBER: 151066055
MAIL ADDRESS:
STREET 1: 481B EDWARD H ROSS DRIVE
CITY: ELMWOOD PARK
STATE: NJ
ZIP: 07407
4
1
dp58947_4-grodman.xml
FORM 4
X0306
4
2015-08-20
1
0000792641
BIO REFERENCE LABORATORIES INC
BRLI
0001189452
GRODMAN MARC
481 EDWARD H. ROSS DRIVE
ELMWOOD PARK
NJ
07407
1
1
0
0
President and CEO
Common Stock
2015-08-20
4
D
0
1937502
D
0
D
Common Stock
2015-08-20
4
D
0
159464
D
0
I
By Trust
Common Stock
2015-08-20
4
D
0
244834
D
0
I
By Spouse and Children
Common Stock
2015-08-20
4
D
0
200000
D
0
I
By Spouse's Trust
Common Stock
2015-08-20
4
D
0
200000
D
0
I
By Trust
As of the effective time of the transactions contemplated by the Agreement and Plan of Merger, dated as of June 3, 2015 (the "Merger Agreement"), by and among the Issuer, OPKO Health, Inc., a Delaware corporation ("OPKO"), and Bamboo Acquisition, Inc., a New Jersey corporation, each share of the Issuer's common stock held by the reporting person was disposed of pursuant to the Merger Agreement in exchange for 2.75 shares of OPKO common stock.
Represents shares held in a successor trust to a grantor retained annuity trust of which Pam Gau Grodman, the reporting person's spouse, and Rich Faherty are trustees.
Represents 145,834 shares directly owned by the reporting person's wife and 99,000 shares owned by their children. The reporting person disclaims beneficial ownership of these 244,834 shares.
Represents 200,000 shares held in trust for the benefit of the reporting person's wife and children, of which the reporting person and Mr. Ariel Fuentes are the co-trustees.
Represents 200,000 shares held in trust for the benefit of the reporting person and children, of which the reporting person's wife is the trustee.
/s/ Marc Grodman
2015-08-20