-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, DC8DS1J9eCo9sca8R1zhkZc6luHV8k9n8I7uvWZpxUt5H0EuVdaRambNLhRozkkP 2wVxjd9uifPf43DBNUhT9g== 0001019687-04-001691.txt : 20040804 0001019687-04-001691.hdr.sgml : 20040804 20040804203952 ACCESSION NUMBER: 0001019687-04-001691 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19961212 FILED AS OF DATE: 20040804 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: dArbeloff George V CENTRAL INDEX KEY: 0001295298 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19627 FILM NUMBER: 04952963 BUSINESS ADDRESS: BUSINESS PHONE: 949-361-1200 MAIL ADDRESS: STREET 1: C/O BIOLASE TECHNOLOGY, INC. STREET 2: 981 CALLE AMANECER CITY: SAN CLEMENTE STATE: CA ZIP: 92673 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BIOLASE TECHNOLOGY 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: 981 CALLE AMANECER CITY: SAN CLEMENTE STATE: CA ZIP: 92673 BUSINESS PHONE: 7143611200 MAIL ADDRESS: STREET 1: 981 CALLE AMANECER CITY: SAN CLEMENTE STATE: CA ZIP: 92673 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 FORMER COMPANY: FORMER CONFORMED NAME: PAMPLONA CAPITAL CORP DATE OF NAME CHANGE: 19911104 4 1 edgar.xml PRIMARY DOCUMENT X0202 4 1996-12-12 0000811240 BIOLASE TECHNOLOGY INC BLTI 0001295298 dArbeloff George V 981 CALLE AMANECER SAN CLEMENTE CA 92673 1 0 0 0 Common Stock owned 18236 D Common Stock 2004-08-03 5 M 0 20000 8.92 A 38236 D Option 12/26/96 3.5625 1996-12-12 5 A 0 8335 A 1997-12-12 2006-12-12 Common 8335 8335 D Option 5/20/97 3.9375 1997-05-20 5 A 0 20000 A 1998-05-20 2007-05-20 Common 20000 20000 D Option 5/19/98 3.9375 1998-05-19 5 A 0 30000 A 1999-05-19 2008-05-19 Common 30000 30000 D Option 5/25/1999 2.0312 1999-05-25 5 A 0 30000 A 2000-05-25 2009-05-25 Common 30000 30000 D Option 5/23/00 2.125 2000-05-23 5 A 0 30000 A 2001-05-23 2010-05-23 Common 30000 30000 D Option exercise 5/23/00 2.125 2004-08-03 5 M 0 20000 8.65 D 2001-05-23 2010-05-23 Common 20000 10000 D Option 5/3/2001 2.22 2001-05-03 5 A 0 30000 A 2002-05-03 2011-05-03 Common 30000 30000 D Option 5/23/2002 5.24 2002-05-23 5 A 0 30000 A 2003-05-23 2012-05-23 Common 30000 30000 D Option 4/29/03 11.07 2003-04-29 5 A 0 30000 A 2003-04-29 2013-04-29 Common 30000 30000 D Option 5/26/2004 11.96 2004-05-26 5 A 0 30000 A 2004-05-26 2014-05-26 Common 30000 30000 D Exercise of stock option granted under the Company's 2002 Stock Incentive Plan, a plan meeting the requirements of 16b-3. Grant of stock option granted under the Company's 2002 Stock Incentive Plan, a plan meeting the requirements of 16b-3. Not applicable. George D'Arbeloff 2004-08-03 -----END PRIVACY-ENHANCED MESSAGE-----