-----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, JlE/t+UsOsY4K4Y2V8ixz2v2ZUcHb1CxhELKlmc0yPzoW8fFYER87ymqmKMtXJa8 0tC+fP0MGuh/GIMGYAU0Jw== 0001019687-05-003170.txt : 20051116 0001019687-05-003170.hdr.sgml : 20051116 20051116184639 ACCESSION NUMBER: 0001019687-05-003170 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20051115 FILED AS OF DATE: 20051116 DATE AS OF CHANGE: 20051116 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: 051210956 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 2005-11-15 0000811240 BIOLASE TECHNOLOGY INC BLTI 0001295298 dArbeloff George V 981 CALLE AMANECER SAN CLEMENTE CA 92673 1 0 0 0 Stock Option (right to buy) 5.81 2005-11-15 4 A 0 30000 0 A 2015-11-14 Common Stock 30000 30000 D The option vests in four equal quarterly installments of 7,500 each beginning three months after the date of grant. /s/ John Hohener, by power of attorney 2005-11-16 -----END PRIVACY-ENHANCED MESSAGE-----