0001261380-12-000024.txt : 20120914 0001261380-12-000024.hdr.sgml : 20120914 20120914201235 ACCESSION NUMBER: 0001261380-12-000024 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120912 FILED AS OF DATE: 20120914 DATE AS OF CHANGE: 20120914 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ANDERSON ROBERT K CENTRAL INDEX KEY: 0000900610 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-27598 FILM NUMBER: 121093780 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: IRIDEX CORP CENTRAL INDEX KEY: 0001006045 STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845] IRS NUMBER: 770210467 STATE OF INCORPORATION: DE FISCAL YEAR END: 1230 BUSINESS ADDRESS: STREET 1: 1212 TERRA BELLA AVE CITY: MOUNTAIN VIEW STATE: CA ZIP: 94043 BUSINESS PHONE: 6509404700 MAIL ADDRESS: STREET 1: 1212 TERRA BELLA AVENUE CITY: MOUNTAIN VIEW STATE: CA ZIP: 94043 4 1 edgar.xml PRIMARY DOCUMENT X0306 4 2012-09-12 0001006045 IRIDEX CORP IRIX 0000900610 ANDERSON ROBERT K 1212 TERRA BELLA AVENUE MOUNTAIN VIEW CA 94043 1 1 0 0 Chairman and CEO Common Stock 2012-09-12 4 A 0 25000 0 A 55396 D Common Stock 73944 I By Spouse Shares are represented by restricted stock units and will vest one hundred percent (100%) on December 31, 2013. /s/Susan Bruce, Attorney-in-Fact for William M. Moore 2012-09-14