0001181431-11-015815.txt : 20110304 0001181431-11-015815.hdr.sgml : 20110304 20110304175804 ACCESSION NUMBER: 0001181431-11-015815 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110302 FILED AS OF DATE: 20110304 DATE AS OF CHANGE: 20110304 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FAGEN DONALD L CENTRAL INDEX KEY: 0001206975 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-11634 FILM NUMBER: 11666018 MAIL ADDRESS: STREET 1: 3400 CENTRAL AVENUE CITY: SANTA CLARA STATE: CA ZIP: 95051 4 1 rrd304118.xml RESTRICTED SHARE GRANT 3-2-11 X0303 4 2011-03-02 0 0000718937 STAAR SURGICAL CO STAA 0001206975 FAGEN DONALD L 1911 WALKER AVE MONROVIA CA 91016 0 1 0 0 V.P. Sales for N. America Common Stock 2011-03-02 4 A 0 3000 0 A 19666 D Restricted shares of Common Stock, subject to forfeiture and vesting in a single installment on March 2, 2012. Includes 3,000 restricted shares vesting on March 2, 2012, and options to purchase 16,666 shares of Common Stock exercisable on or before June 2, 2011. /s/Charles Kaufman as attorney-in-fact for Donald L. Fagen 2011-03-04