Biolase (BIOLQ) Form 3 BIOLASE / Steven Sandor ownership change

SEC Form 3

FORM 3

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940

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1. Name and Address of Reporting Person^*

Sandor Steven

(Last) (First) (Middle)

27042 TOWNE CENTRE DRIVE

SUITE 270

(Street)

FOOTHILL RANCH CA 92610

(City) (State) (Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
07/06/2022

3. Issuer Name and Ticker or Trading Symbol
BIOLASE, INC [ BIOL ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

	Director	10% Owner
X	Officer (give title below)	Other (specify below)
Chief Operating Officer

5. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

X	Form filed by One Reporting Person
	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4)	2. Amount of Securities Beneficially Owned (Instr. 4)	3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock	2,355	D

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4)	2. Date Exercisable and Expiration Date (Month/Day/Year)		3. Title and Amount of Securities Underlying Derivative Security (Instr. 4)		4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
	Date Exercisable	Expiration Date	Title	Amount or Number of Shares
Restricted Stock Unit	(1)	(1)	Common Stock	200	(2)	D
Restricted Stock Unit	(3)	(3)	Common Stock	1,800	(2)	D
Restricted Stock Unit	(4)	(4)	Common Stock	450	(2)	D
Restricted Stock Unit	(5)	(5)	Common Stock	8,544	(2)	D
Stock Option (right to buy)	(6)	04/08/2029	Common Stock	800	52.75	D

Explanation of Responses:

1. The restricted stock unit award vests as to 200 shares on April 8, 2023, subject to the Reporting Person's continued service with the Company.

2. At the option of the Company, each restricted stock unit represents the right to receive, at settlement, one share of common stock, or its cash equivalent.

3. The restricted stock unit award vests as to 900 shares on each of August 10, 2022 and August 10, 2023, subject to the Reporting Person's continued service with the Company.

4. The restricted stock unit award vests as to 450 shares on August 5, 2022, subject to the Reporting Person's continued service with the Company.

5. 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.

6. The stock option vests immediately as to 201 shares, and the remainder vests ratably over a 36-month period, commencing on May 8, 2020, subject to the Reporting Person's continued service with the Company.

Remarks:

	/s/ Michael C. Carroll, attorney-in-fact for Steven Sandor	07/14/2022
	** Signature of Reporting Person	Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.