0000899243-22-001919.txt : 20220113 0000899243-22-001919.hdr.sgml : 20220113 20220113171521 ACCESSION NUMBER: 0000899243-22-001919 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20220111 FILED AS OF DATE: 20220113 DATE AS OF CHANGE: 20220113 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Wong Kendra CENTRAL INDEX KEY: 0001903906 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39473 FILM NUMBER: 22529775 MAIL ADDRESS: STREET 1: C/O LENSAR, INC. STREET 2: 2800 DISCOVERY DRIVE, SUITE 100 CITY: ORLANDO STATE: FL ZIP: 32826 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: LENSAR, Inc. CENTRAL INDEX KEY: 0001320350 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 320125724 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2800 DISCOVERY DRIVE STREET 2: SUITE 100 CITY: ORLANDO STATE: FL ZIP: 32826 BUSINESS PHONE: 888-536-7271 MAIL ADDRESS: STREET 1: 2800 DISCOVERY DRIVE STREET 2: SUITE 100 CITY: ORLANDO STATE: FL ZIP: 32826 FORMER COMPANY: FORMER CONFORMED NAME: LensAR Inc DATE OF NAME CHANGE: 20070703 FORMER COMPANY: FORMER CONFORMED NAME: LaserSoft Vision Inc DATE OF NAME CHANGE: 20050310 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2022-01-11 0 0001320350 LENSAR, Inc. LNSR 0001903906 Wong Kendra C/O LENSAR, INC. 2800 DISCOVERY DRIVE ORLANDO FL 32826 0 1 0 0 Principal Accounting Officer Common Stock 7336 D Stock Option (Right to Buy) 7.23 2031-04-01 Common Stock 5330 D The options vests as to 25% of the award on April 1, 2022 and, as to the remaining amount of the award, in thirty-six (36) substantially equal monthly installments thereafter, subject to the Reporting Person's continued service to the Issuer through the application vesting date. Exhibit 24 - Power of Attorney. /s/ Thomas R. Staab, II, Attorney-in-Fact 2022-01-13 EX-24 2 attachment1.htm EX-24 DOCUMENT
                                                                     EXHIBIT 24

                                POWER OF ATTORNEY

With respect to holdings of and transactions in securities issued by LENSAR,
Inc. (the "Company"), the undersigned hereby constitutes and appoints the
individuals named on Schedule A attached hereto and as may be amended from time
to time, or any of them signing singly, with full power of substitution and
resubstitution, to act as the undersigned's true and lawful attorney-in-fact
to:

      1. prepare, execute in the undersigned's name and on the undersigned's
         behalf, and submit to the United States Securities and Exchange
         Commission (the "SEC") a Form ID, including amendments thereto, and
         any other documents necessary or appropriate to obtain and/or
         regenerate codes and passwords enabling the undersigned to make
         electronic filings with the SEC of reports required by Section 16(a)
         of the Securities Exchange Act of 1934, as amended, or any rule or
         regulation of the SEC;

      2. execute for and on behalf of the undersigned, Forms 3, 4, and 5 in
         accordance with Section 16 of the Securities Exchange Act of 1934, as
         amended, and the rules thereunder;

      3. do and perform any and all acts for and on behalf of the undersigned
         which may be necessary or desirable to complete and execute any such
         Form 3, 4, or 5, complete and execute any amendment or amendments
         thereto, and timely file such form with the SEC and any stock exchange
         or similar authority; and

      4. take any other action of any type whatsoever in connection with the
         foregoing which, in the opinion of such attorney-in-fact, may be of
         benefit to, in the best interest of, or legally required by, the
         undersigned, it being understood that the documents executed by such
         attorney-in-fact on behalf of the undersigned pursuant to this Power
         of Attorney shall be in such form and shall contain such terms and
         conditions as such attorney-in-fact may approve in such attorney-in-
         facts discretion.

The undersigned hereby grants to each such attorney-in-fact full power and
authority to do and perform any and every act and thing whatsoever requisite,
necessary, or proper to be done in the exercise of any of the rights and powers
herein granted, as fully to all intents and purposes as the undersigned might
or could do if personally present, with full power of substitution and
resubstitution or revocation, hereby ratifying and confirming all that such
attorney-in-fact, or such attorneys-in-fact substitute or substitutes, shall
lawfully do or cause to be done by virtue of this Power of Attorney and the
rights and powers herein granted.

The undersigned acknowledges that the foregoing attorneys-in-fact, in serving
in such capacity at the request of the undersigned, are not assuming, nor is
any Company assuming, any of the undersigned's responsibilities to comply with
Section 16 of the Securities Exchange Act of 1934, as amended.

This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4, and 5 with respect to the
undersigned's holdings of and transactions in securities issued by the Company,
unless earlier revoked by the undersigned in a signed writing delivered to the
foregoing attorneys-in-fact.

IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of this 4th day of January 2022.

                                 By: /s/ Kendra W. Wong

                                 Name: Kendra W. Wong


                                Schedule A

         Individuals Appointed as Attorney-in-Fact with Full Power of
Substitution and Resubstitution

      1. Nicholas T. Curtis
      2. Thomas R. Staab, II