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SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 12b-25
Commission File Number 0-19627
NOTIFICATION OF LATE FILING
(Check One): [ ] Form 10-K [ ] Form 11-K [ ] Form 20-F [X] Form 10-Q
[ ] Form N-SAR
For Period Ended: September 30, 1996
[ ] Transition Report on Form 10-K [ ] Transition Report on Form 10-Q
[ ] Transition Report on Form 20-K [ ] Transition Report on Form N-SAR
[ ] Transition Report on Form 11-K
For the Transition Period Ended: N/A
Read attached instructions sheet before preparing form. Please print or
type.
Nothing in this form shall be construed to imply that the Commission
has verified any information contained herein.
If the notification relates to a portion of the filing checked above,
identify the Item(s) to which the notification relates: N/A
PART I - REGISTRANT INFORMATION
Full name of registrant BioLase Technology, Inc.
Former name if applicable
Address of principal executive office (street and number)
981 Calle Amanecer
City, State and Zip Code San Clemente, CA 92673
PART II - RULE 12b-25 (b) and (c)
If the subject report could not be filed without unreasonable effort or
expense and the registrant seeks relief pursuant to Rule 12b-25 (b), the
following should be completed. (Check appropriate box.)
[X] (a) The reason described in reasonable detail in Part III of this form
could not be eliminated without unreasonable effort or expense;
[X] (b) The subject annual report, semi-annual report, transition report on
Form 10-K, 20-F, 11-K or Form N-SAR, or portion thereof will be filed on or
before the 15th calendar day following the prescribed due date; or the
subject quarterly report or transition report on Form 10-Q or portion
thereof will be filed on or before the fifth calendar day following the
prescribed due date; and
[ ] (c) The accountant's statement or other exhibit required by Rule 12b-25(c)
has been attached if applicable.
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PART III - NARRATIVE
State below in reasonable detail the reasons why Form 10-K, 11-K, 20-F,
10-Q, N-SAR or the transition report portion thereof could not be filed within
the prescribed time period. (Attach extra sheets if needed.)
The Company has not completed the compilation of all necessary
financial data and has not had the opportunity to have the data examined
in final form by its independent accountants. Accordingly, the Company
is unable to timely file its Quarterly Report on Form 10-QSB without
unreasonable effort and expense.
The Company anticipates the filing of its Report to occur no
later than Tuesday, November 19, 1996, in accordance with the extension
period specified within Rule 12b-25, section (b)(2)(ii) of the
Regulations under the Securities Exchange Act of 1934.
PART IV - OTHER INFORMATION
(1) Name and telephone number of person to contact in regard to this
notification
Stephen R. Tartamella 714 361-1200, extension 112
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(Name) (Area Code) (Telephone Number)
(2) Have all other periodic report required under Section 13 or 15(d)
of the Securities Exchange Act of 1934 or section 30 of the Investment Company
Act of 1940 during the preceding 12 months or for such shorter period that the
registrant was required to file such a report(s) been filed? If the answer is
no, identify report(s).
[X] Yes [ ] No
(3) Is it anticipated that any significant change in results of
operations from the corresponding period for the last fiscal year will be
reflected by the earnings statements to be included in the subject report or
portion thereof?
[X] Yes [ ] No
If so, attach an explanation of the anticipated change, both
narratively and quantitatively, and, if appropriate, state the reasons why a
reasonable estimate of the results cannot be made.
The Company's primary focus during the three and nine-month
periods ended September 30, 1996 was on the development of new
technology and related products. As a result, revenues are anticipated
to be significantly lower and net loss higher than the corresponding
periods of the previous fiscal year. Revenues for the three and
nine-month periods ended September 30, 1996 are expected to be between
thirty and forty-two percent of the $441,000 and $1,033,000 reported,
respectively, for the three and nine-month periods ended September 30,
1995. The net loss for the three months ended September 30, 1996 is
expected to be more than double the $256,000 loss reported for the 1995
quarter, and the net loss for the nine months ended September 30, 1996
is expected to exceed the $1,430,000 loss reported for the comparable
1995 period by between fifteen and twenty percent.
BioLase Technology, Inc.
(Name of registrant as specified in charter)
Has caused this notification to be signed on its behalf by the undersigned
thereunto duly authorized.
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Date November 15, 1996 By /s/ Stephen R. Tartamella
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Stephen R. Tartamella, Chief Financial Officer
Instruction. The form may be signed by an executive officer of the
registrant or by any other duly authorized representative. The name and title
of the person signing the form shall be typed or printed beneath the signature.
If the statement is signed on behalf of the registrant by an authorized
representative (other than an executive officer), evidence of the
representative's authority to sign on behalf of the registrant shall be filed
with the form.
GENERAL INSTRUCTIONS
1. This form is required by Rule 12b-25 of the General Rules and
Regulations under the Securities Exchange Act of 1934.
2. One signed original and four conformed copies of this form and
amendments thereto must be completed and filed with the Securities and Exchange
Commission, Washington, D.C. 20549, in accordance with Rule 0-3 of the General
Rules and Regulations under the Act. The information contained in or filed with
the form will be made a matter of the public record in the Commission files.
3. A manually signed copy of the form and amendments thereto shall be
filed with each national securities exchange on which any class of securities
of the registrant is registered.
4. Amendments to the notifications must also be filed on Form 12b-25
but need not restate information that has been correctly furnished. The form
shall be clearly identified as an amended notification.
