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