0001140361-12-013608.txt : 20120306
0001140361-12-013608.hdr.sgml : 20120306
20120306212818
ACCESSION NUMBER: 0001140361-12-013608
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20120302
FILED AS OF DATE: 20120306
DATE AS OF CHANGE: 20120306
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Subrin Philippe
CENTRAL INDEX KEY: 0001527887
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-11634
FILM NUMBER: 12672317
MAIL ADDRESS:
STREET 1: 1911 WALKER AVENUE
CITY: MONROVIA
STATE: CA
ZIP: 91016
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: STAAR SURGICAL CO
CENTRAL INDEX KEY: 0000718937
STANDARD INDUSTRIAL CLASSIFICATION: OPHTHALMIC GOODS [3851]
IRS NUMBER: 953797439
STATE OF INCORPORATION: DE
FISCAL YEAR END: 0101
BUSINESS ADDRESS:
STREET 1: 1911 WALKER AVE
CITY: MONROVIA
STATE: CA
ZIP: 91016
BUSINESS PHONE: 6263037902
MAIL ADDRESS:
STREET 1: 1911 WALKER AVE
CITY: MONROVIA
STATE: CA
ZIP: 91016
FORMER COMPANY:
FORMER CONFORMED NAME: STAAR SURGICAL COMPANY
DATE OF NAME CHANGE: 19920703
4
1
doc1.xml
FORM 4
X0304
4
2012-03-02
0
0000718937
STAAR SURGICAL CO
STAA
0001527887
Subrin Philippe
1911 WALKER AVENUE
MONROVIA
CA
91016
0
1
0
0
VP Switzerland OP
Common Stock
2012-03-02
4
A
0
7500
0
A
49000
D
Common Stock Options
11.00
2012-03-02
4
A
0
20000
0
A
2022-03-02
Common Stock
20000
20000
D
Performance Accelerated Restricted Shares (PARS), subject to forfeiture and vesting in a single installment on March 2, 2015, but subject to accelerated vesting as to 1/3 of the shares each year pursuant to achievement of certain performance criteria.
Includes 7,500 PARS subject fo forfeiture and vesting on March 15, 2014 and 7,500 PARS subject to forfeiture and vesting on March 2, 2015.
The options first become exercisable as follows: 6,667 on March 2, 2013, 6,667 on March 2, 2014 and 6,666 on March 2, 2015.
Following the transactions reported on this Form 4, Mr. Subrin's total beneficial ownership (as defined in Rule 13d-3 under the Exchange Act) is 198,999 shares of Common Stock, which includes 149,999 vested stock options that are vested or will vest in the next 60 days and 15,000 PARS. He also holds 70,001 unvested stock options.
/s/ Charles Kaufman as Attorney-in-Fact for Phillipe Subrin
2012-03-06