-----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, A6lVMEHpQwqMfXmR4x9Ot4Mx42W9uuUgDjV4fOeBdUKbLCKiUefy+nWm5TF5njHM ajdwkRGE//KHBHUexv2/lQ== 0001209191-09-028363.txt : 20090522 0001209191-09-028363.hdr.sgml : 20090522 20090522140415 ACCESSION NUMBER: 0001209191-09-028363 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20090520 FILED AS OF DATE: 20090522 DATE AS OF CHANGE: 20090522 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DURRIE DANIEL S CENTRAL INDEX KEY: 0001358010 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19627 FILM NUMBER: 09848629 MAIL ADDRESS: STREET 1: C/O BIOLASE TECHNOLOGY INC STREET 2: 4 CROMWELL CITY: IRVINE STATE: CA ZIP: 92618 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: 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: 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 doc4.xml FORM 4 SUBMISSION X0303 4 2009-05-20 0 0000811240 BIOLASE TECHNOLOGY INC BLTI 0001358010 DURRIE DANIEL S 4 CROMWELL IRVINE CA 92618 1 0 0 0 Stock Option (right to buy) 1.24 2009-05-20 4 A 0 15000 0.00 A 2019-05-20 Common Stock 15000 15000 D Each automatic option is immediately exercisable for all of the option shares. However, any shares purchased under such option are subject to repurchase by the Issuer, at the lower of the exercise price paid per share or the fair market value per share (determined at the time of repurchase), should the Reporting Person cease Board service prior to vesting of those shares. The shares vest, and the Company's right of repurchase lapses, in four successive quarterly installments upon the Reporting Person's completion of each quarter of service as a non-employee director measured from the grant date. The shares subject to the option grant will immediately vest in full if certain changes in control or ownership occur or if the Reporting Person dies or becomes disabled while serving as a director. /s/ Frederick M. Capallo, Attorney-in-Fact for Daniel S. Durrie 2009-05-22 -----END PRIVACY-ENHANCED MESSAGE-----