Salesh Balak - 19 Aug 2021 Form 4 Insider Report for UNIVERSAL BIOSENSORS INC

Role: Chief Financial Officer
Signature: /s/ Salesh Balak
Issuer symbol: N/A
Transactions as of: 19 Aug 2021
Net transactions value: $0
Form type: 4
Filing time: 14 Sep 2021, 20:26:13 UTC
Next filing: 28 Feb 2022
SEC: View on sec.gov

Transactions Table

Type	Sym	Class	Transaction	Value $	Shares	Change %	* Price $	Shares After	Date	Ownership	Footnotes
transaction	UBI	Common Stock	Options Exercise	$0	+40,000	+15%	$0.000000	306,558	19 Aug 2021	Direct	F1

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type	Sym	Class	Transaction	Value $	Shares	Change %	* Price $	Shares After	Date	Underlying Class	Amount	Exercise Price	Ownership	Footnotes
transaction	UBI	Performance Rights	Award	$0	+500,000		$0.000000	500,000	19 Aug 2021	Common Stock	500,000		Direct	F7
transaction	UBI	Performance Rights	Award	$0	+250,000		$0.000000	250,000	19 Aug 2021	Common Stock	250,000		Direct	F8
transaction	UBI	Stock Option (Right to Buy)	Options Exercise	$0	-40,000	-100%	$0.000000^*	0	19 Aug 2021	Common Stock	40,000	$0.000000	Direct	F6
holding	UBI	Stock Option (Right to Buy)						500,000	19 Aug 2021	Common Stock	500,000	$0.3000	Direct	F2, F3
holding	UBI	Stock Option (Right to Buy)						721,000	19 Aug 2021	Common Stock	721,000	$0.5000	Direct	F2, F4
holding	UBI	Stock Option (Right to Buy)						216,300	19 Aug 2021	Common Stock	216,300	$0.5000	Direct	F2, F5

* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id	Content
F1	Includes (i) 302,392 shares in the form of CDIs Mr. Balak holds directly and (ii) 4,166 restricted fully paid shares.
F2	The price reported is stated in Australian dollars.
F3	The options are fully vested but can only be exercised after 03/01/2021.
F4	206,000 of the stock options vested and became exercisable on 10/05/2016, 412,000 of the stock options vested and became exercisable on 12/31/2016 and 103,000 of the stock options vested and became exercisable on 02/23/2017.
F5	216,300 stock options vested and became exercisable on 12/31/2017.
F6	13,333 stock options vested and became exercisable on 12/31/2015, 13,333 stock options vested and became exercisable on 12/31/2016, and 13,334 stock options vested and became exercisable on 12/31/2017. These options were exercised on 08/19/2021.
F7	Each performance right represents a contingent right to receive one share of common stock of Universal Biosensors, Inc. ("UBI"). The performance rights vest upon, among other triggers, UBI's market capitalization having achieved a specified threshold.
F8	Each performance right represents a contingent right to receive one share of common stock of UBI. The performance rights vest upon a change of control transaction with a value greater a specified threshold.