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4//SEC Filing

BIOLASE, INC 4

Accession 0001209191-17-042885

CIK 0000811240operating

Filed

Jul 2, 8:00 PM ET

Accepted

Jul 3, 5:49 PM ET

Size

9.5 KB

Accession

0001209191-17-042885

Insider Transaction Report

Form 4
Period: 2017-06-30
Flynn Harold C Jr.
DirectorPresident and CEO
Transactions
  • Conversion

    Common Stock

    2017-06-30$1.24/sh+30,700$38,06866,100 total(indirect: By Trust)
  • Conversion

    Series D Participating Convertible Preferred Stock

    2017-06-303070 total(indirect: By Trust)
    Exercise: $1.24From: 2017-06-30Common Stock (30,700 underlying)
Holdings
  • Common Stock

    96,720
Footnotes (6)
  • [F1]On June 30, 2017, as a result of receipt of the Requisite Stockholder Approval (defined and described further in the Securities Purchase Agreement dated April 11, 2017 and filed as Exhibit 99.1 to the Current Report on Form 8-K filed by the Issuer on April 14, 2017), each share of Preferred Stock (as defined below) automatically converted into 100 shares of Common Stock, reflecting a conversion price equal to $1.24 per share.
  • [F2]The Common Stock is held directly by the Flynn Living Trust (the "Trust"). Mr. Flynn serves as a co-trustee to the Trust and his daughter is the beneficiary of the Trust.
  • [F3]These shares of Series D Participating Convertible Preferred Stock ("Preferred Stock") were acquired by the Trust in a private placement with the Issuer, which closed on April 18, 2017.
  • [F4]The Preferred Stock had no expiration date.
  • [F5]The Preferred Stock was held directly by the Trust. Mr. Flynn serves as a co-trustee to the Trust and his daughter is the beneficiary of the Trust.
  • [F6]The Reporting Person disclaims beneficial ownership of the Preferred Stock except to the extent of his pecuniary interest therein, and this report shall not be deemed an admission that the Reporting Person is the beneficial owner of the Preferred Stock for purposes of Section 16 of the Securities Exchange Act of 1934, as amended, or for any other purpose.

Issuer

BIOLASE, INC

CIK 0000811240

Entity typeoperating
IncorporatedDE

Related Parties

1
  • filerCIK 0000811240

Filing Metadata

Form type
4
Filed
Jul 2, 8:00 PM ET
Accepted
Jul 3, 5:49 PM ET
Size
9.5 KB