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