-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, HwTB98wc0+4xYHC78+FDp7lexhoadoK1r2IfGd/vi4ErSnNkUatKmgrE3MU/XYqO 3Q2mIYAQKGP01qS9zgtcWA== 0001181431-10-061044.txt : 20101213 0001181431-10-061044.hdr.sgml : 20101213 20101213152344 ACCESSION NUMBER: 0001181431-10-061044 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20101206 FILED AS OF DATE: 20101213 DATE AS OF CHANGE: 20101213 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Kamijo Isamu CENTRAL INDEX KEY: 0001489053 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-11634 FILM NUMBER: 101247781 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 rrd294008.xml FORM 4 I. KAMIJO X0303 4 2010-12-06 0 0000718937 STAAR SURGICAL CO STAA 0001489053 Kamijo Isamu 1911 WALKER AVE MONROVIA CA 91016 0 1 0 0 President, STAAR Japan Inc. Common Stock 2010-12-06 4 M 0 16666 2.21 A 40000 D Common Stock 2010-12-06 4 S 0 16666 5.52 D 23334 D Common Stock Options 2.21 2010-12-06 4 M 0 16666 0 D 2018-01-07 Common Stock 16666 8334 D Includes options to purchase 8,334 shares of common stock exercisable on or before February 6, 2011 and 5,000 shares of restricted stock subject to forfeiture prior to vesting on March 5, 2011. The options vest(ed) as follows: 8,333 shares on 1/8/2009, 8,333 shares on 1/8/2010 and 8,334 shares on 1/8/2011. The reported transaction is the exercise by Mr. Kamijo of options to purchase 16,666 shares of Common Stock on December 6, 2010 and sale of the resulting shares on the same date. /s/Charles Kaufman as Attorney-in-Fact for Isamu Kamijo 2010-12-13 -----END PRIVACY-ENHANCED MESSAGE-----