0001209191-17-008727.txt : 20170208 0001209191-17-008727.hdr.sgml : 20170208 20170208170343 ACCESSION NUMBER: 0001209191-17-008727 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170206 FILED AS OF DATE: 20170208 DATE AS OF CHANGE: 20170208 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: Flynn Harold C Jr. CENTRAL INDEX KEY: 0001647860 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36385 FILM NUMBER: 17583315 MAIL ADDRESS: STREET 1: 4 CROMWELL CITY: IRVINE STATE: CA ZIP: 92618 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2017-02-06 0 0000811240 BIOLASE, INC BIOL 0001647860 Flynn Harold C Jr. C/O 4 CROMWELL IRVINE CA 92618 1 1 0 0 President and CEO Restricted Stock Unit 2017-02-06 4 A 0 1000000 0.00 A Common Stock 1000000 1464761 D Each restricted stock unit represents the right to receive, at settlement, one share of common stock. The restricted stock units vest as follows: (i) one-quarter of the restricted stock units vest on the two-year anniversary of the award date, (ii) one-eighth of the restricted stock units vest on the three-year anniversary of the award date, (iii) one-eighth of the restricted stock units vest on the fourth-year anniversary of the award date, and (iv) one-half of the restricted stock units vest based upon specific performance criteria, subject to the Reporting Person's continued service with the Company through the applicable vesting dates. /s/ Michael C. Carroll, attorney-in-fact for Harold C. Flynn, Jr. 2017-02-08