0001209191-11-027004.txt : 20110509 0001209191-11-027004.hdr.sgml : 20110509 20110509170150 ACCESSION NUMBER: 0001209191-11-027004 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110505 FILED AS OF DATE: 20110509 DATE AS OF CHANGE: 20110509 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LICHTWARDT GREGORY CENTRAL INDEX KEY: 0001271162 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19627 FILM NUMBER: 11824215 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 2011-05-05 0 0000811240 BIOLASE TECHNOLOGY INC BLTI 0001271162 LICHTWARDT GREGORY C/O 4 CROMWELL IRVINE CA 92618 1 0 0 0 Stock Option (right to buy) 5.34 2011-05-05 4 A 0 20000 0.00 A 2021-05-05 Common Stock 20000 69750 D Stock Option (right to buy) 5.34 2011-05-05 4 A 0 21000 0.00 A 2016-05-05 Common Stock 21000 90750 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 Issuer'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. The option is immediately exercisable for all of the option shares. The shares vest 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/ Michael C. Carroll, attorney-in-fact for Gregory E. Lichtwardt 2011-05-09