0001209191-17-055649.txt : 20171004 0001209191-17-055649.hdr.sgml : 20171004 20171004122807 ACCESSION NUMBER: 0001209191-17-055649 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171002 FILED AS OF DATE: 20171004 DATE AS OF CHANGE: 20171004 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BEAVER JOHN R CENTRAL INDEX KEY: 0001215999 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36385 FILM NUMBER: 171120957 MAIL ADDRESS: STREET 1: C/O STERLING CHEMICALS INC STREET 2: 1200 SMITH STREET CITY: HOUSTON STATE: TX ZIP: 77002 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 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2017-10-02 0 0000811240 BIOLASE, INC BIOL 0001215999 BEAVER JOHN R 4 CROMWELL IRVINE CA 92618 0 1 0 0 SVP & Chief Financial Officer Stock Option (right to buy) 0.59 2017-10-02 4 A 0 600000 0.00 A 2027-10-02 Common Stock 600000 600000 D The stock option vests as follows: 100,000 option shares vest on the one-year anniversary of grant, 300,000 option shares vest in equal monthly amounts over a 36-month period, commencing on the 13th month anniversary of the date of grant, and 200,000 option shares vest in accordance with performance-based criteria established by the Compensation Committee of the Board of Directors. The vesting of the stock option is subject to the Reporting Person's continued service with the Company through the applicable vesting dates. /s/ Michael C. Carroll, attorney-in-fact for John R. Beaver 2017-10-04