0000899243-16-034305.txt : 20161123 0000899243-16-034305.hdr.sgml : 20161123 20161123161027 ACCESSION NUMBER: 0000899243-16-034305 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161108 FILED AS OF DATE: 20161123 DATE AS OF CHANGE: 20161123 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BIOLASE, INC CENTRAL INDEX KEY: 0000811240 STANDARD INDUSTRIAL CLASSIFICATION: DENTAL EQUIPMENT & SUPPLIES [3843] IRS NUMBER: 870442441 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 4 CROMWELL CITY: IRVINE STATE: CA ZIP: 92618 BUSINESS PHONE: 949-361-1200 MAIL ADDRESS: STREET 1: 4 CROMWELL CITY: IRVINE STATE: CA ZIP: 92618 FORMER COMPANY: FORMER CONFORMED NAME: BIOLASE TECHNOLOGY INC DATE OF NAME CHANGE: 19941117 FORMER COMPANY: FORMER CONFORMED NAME: LASER MEDICAL TECHNOLOGY INC DATE OF NAME CHANGE: 19941117 FORMER COMPANY: FORMER CONFORMED NAME: LASER ENDO TECHNIC CORP DATE OF NAME CHANGE: 19920708 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Flynn Harold C Jr. CENTRAL INDEX KEY: 0001647860 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-36385 FILM NUMBER: 162016697 MAIL ADDRESS: STREET 1: 4 CROMWELL CITY: IRVINE STATE: CA ZIP: 92618 4/A 1 doc4a.xml FORM 4/A SUBMISSION X0306 4/A 2016-11-08 2016-11-14 0 0000811240 BIOLASE, INC BIOL 0001647860 Flynn Harold C Jr. C/O BIOLASE, INC. 4 CROMWELL IRVINE CA 92618 1 1 0 0 President and CEO Stock Option (right to buy) 1.45 2016-11-08 4 A 0 1000000 0.00 A 2026-11-08 Common Stock 1000000 2307903 D Restricted Stock Unit 2016-11-08 4 A 0 0 0.00 A Common Stock 0 652500 D One-half of the stock options vest on the second anniversary of the grant date, and the remaining one-half vests ratably on a monthly basis over a two-year period commencing one month following the second anniversary of the grant date, subject to the Reporting Person's continued service with the Company through the applicable vesting dates. Each restricted stock unit represents the right to receive, at settlement, one share of common stock. On November 23, 2016, the Company and the Reporting Person entered into a letter agreement cancelling the November 8, 2016 restricted stock unit award representing the Reporting Person's right to acquire 1,000,000 shares of the Company's common stock because it was issued in excess of the limitations under the BIOLASE, Inc. 2002 Stock Incentive Plan, as amended. The restricted stock units vest based upon specific performance criteria, subject to the Reporting Person's continued service with the Company through the applicable vesting dates. /s/ Michael C. Carroll, attorney-in-fact 2016-11-23