0001209191-18-052142.txt : 20180925 0001209191-18-052142.hdr.sgml : 20180925 20180925160926 ACCESSION NUMBER: 0001209191-18-052142 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180921 FILED AS OF DATE: 20180925 DATE AS OF CHANGE: 20180925 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Norbe Todd CENTRAL INDEX KEY: 0001743526 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36385 FILM NUMBER: 181085799 MAIL ADDRESS: STREET 1: 7 RUNNING BROOK DRIVE CITY: TRABUCO CANYON STATE: CA ZIP: 92679 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 2018-09-21 0 0000811240 BIOLASE, INC BIOL 0001743526 Norbe Todd 4 CROMWELL IRVINE CA 92618 1 1 0 0 President and CEO Restricted Stock Unit 2018-09-21 4 A 0 350000 0.00 A Common Stock 350000 361945 D Restricted Stock Unit 2018-09-21 4 A 0 300000 0.00 A Common Stock 300000 661945 D Each restricted stock unit represents the right to receive, at settlement, one share of common stock. The restricted stock unit award vests as follows: (i) 116,667 restricted stock units shall vest on the first anniversary of the Reporting Person's first date of employment with the Company, (ii) 58,333 restricted stock units shall vest on the eighteen month anniversary of the Reporting Person's first date of employment with the Company, (iii) 58,333 restricted stock units shall vest on the second anniversary of the Reporting Person's first date of employment with the Company, (iv) 58,333 restricted stock units shall vest on the thirtieth month anniversary of the Reporting Person's first date of employment with the Company, and (v) 58,334 restricted stock units shall vest on the third anniversary of the Reporting Person's first date of employment with the Company, subject to the Reporting Person's continued service with the Company. The restricted stock unit award vests in accordance with performance criteria established by the Compensation Committee of the Company, subject to the Reporting Person's continued service with the Company. /s/ Michael C. Carroll, attorney-in-fact for Todd Norbe 2018-05-25