0001463205-12-000018.txt : 20121004 0001463205-12-000018.hdr.sgml : 20121004 20121004193751 ACCESSION NUMBER: 0001463205-12-000018 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20121002 FILED AS OF DATE: 20121004 DATE AS OF CHANGE: 20121004 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Roberts Kent Charles II CENTRAL INDEX KEY: 0001526142 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19709 FILM NUMBER: 121130617 MAIL ADDRESS: STREET 1: 1146 OXFORD ROAD CITY: SAN MARINO STATE: CA ZIP: 91108 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BIOLARGO, INC. CENTRAL INDEX KEY: 0000880242 STANDARD INDUSTRIAL CLASSIFICATION: CHEMICALS & ALLIED PRODUCTS [2800] IRS NUMBER: 650159115 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 16150 HERON AVENUE CITY: LA MIRADA STATE: CA ZIP: 90638 BUSINESS PHONE: 949-643-9540 MAIL ADDRESS: STREET 1: 16150 HERON AVENUE CITY: LA MIRADA STATE: CA ZIP: 90638 FORMER COMPANY: FORMER CONFORMED NAME: NUWAY MEDICAL INC DATE OF NAME CHANGE: 20030205 FORMER COMPANY: FORMER CONFORMED NAME: NUWAY ENERGY INC DATE OF NAME CHANGE: 20010815 FORMER COMPANY: FORMER CONFORMED NAME: LATIN AMERICAN CASINOS INC DATE OF NAME CHANGE: 19960520 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2012-10-02 0 0000880242 BIOLARGO, INC. BLGO 0001526142 Roberts Kent Charles II 1146 OXFORD ROAD SAN MARINO CA 91108 1 0 0 0 Option to purchase common stock 0.4 2012-10-02 4 A 0 37500 0 A 2012-10-02 2022-10-02 Common Stock 37500 733671 D Option to purchase common stock 0.4 2012-10-02 4 A 0 10000 0 A 2013-10-02 2022-10-02 Common Stock 10000 743671 D This Option was issued to the Reporting Person in exchange for a reduction of $10,000 in fees owed by the Issuer for services on its board of directors. The options issued to Reporting Person reported on this Form 4 are held directly by Reporting Person. The total number of derivative securities beneficially owned by Reporting Person reported in Column 9 includes options to purchase an aggregate 542,858 shares of the Issuer's common stock held indirectly by Reporting Person through a corporation wholly owned by Reporting Person. This Option was issued to the Reporting Person pursuant to the terms of the Issuer's 2007 Equity Incentive Plan, as amended, as an automatic grant to a non-employee Director. Kent C Roberts II 2012-10-04