0001140361-16-051675.txt : 20160211 0001140361-16-051675.hdr.sgml : 20160211 20160211121623 ACCESSION NUMBER: 0001140361-16-051675 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160209 FILED AS OF DATE: 20160211 DATE AS OF CHANGE: 20160211 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: Jack W. Schuler Living Trust CENTRAL INDEX KEY: 0001661351 STATE OF INCORPORATION: IL FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36385 FILM NUMBER: 161409839 BUSINESS ADDRESS: STREET 1: 100 NORTH FIELD DRIVE STREET 2: SUITE 360 CITY: LAKE FOREST STATE: IL ZIP: 60045 BUSINESS PHONE: 224-880-1210 MAIL ADDRESS: STREET 1: 100 NORTH FIELD DRIVE STREET 2: SUITE 360 CITY: LAKE FOREST STATE: IL ZIP: 60045 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SCHULER JACK W CENTRAL INDEX KEY: 0001021412 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36385 FILM NUMBER: 161409840 MAIL ADDRESS: STREET 1: 100 N. FIELD DRIVE STREET 2: SUITE 360 CITY: LAKE FOREST STATE: IL ZIP: 60045 4 1 doc1.xml FORM 4 X0306 4 2016-02-09 0 0000811240 BIOLASE, INC BIOL 0001021412 SCHULER JACK W 100 NORTH FIELD DRIVE SUITE 360 LAKE FOREST IL 60045 0 0 1 0 0001661351 Jack W. Schuler Living Trust 100 NORTH FIELD DRIVE SUITE 360 LAKE FOREST IL 60045 0 0 1 0 Common Stock 2016-02-09 4 P 0 13026 0.7896 A 6469670 I By Trust Common Stock 2016-02-10 4 P 0 54187 0.7742 A 6523857 I By Trust Common Stock 14800 I By Spouse These shares are held by the Jack W. Schuler Living Trust (the "Trust"). Mr. Schuler serves as sole trustee to the Trust. This price reflects the weighted average purchase price for open-market purchases of shares of Common Stock ("Shares") made by the Reporting Persons on February 9, 2016, within a $1.00 range. The actual prices for these transactions range from $.7601 to $.80, inclusive. The Reporting Persons further undertake to provide upon request by the Commission staff, the Issuer, or a security holder of the Issuer, full information regarding the number of shares purchased at each separate price within the ranges set forth in footnotes (2) and (3) to this Form 4. This price reflects the weighted average purchase price for open-market purchases of Shares made by the Reporting Persons on February 10, 2016, within a $1.00 range. The actual prices for these transactions range from $0.765 to $0.78, inclusive. /s/ Jack Schuler, as self and as Trustee of the Jack W. Schuler Living Trust 2016-02-11