0001181431-11-018869.txt : 20110317 0001181431-11-018869.hdr.sgml : 20110317 20110317213417 ACCESSION NUMBER: 0001181431-11-018869 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110315 FILED AS OF DATE: 20110317 DATE AS OF CHANGE: 20110317 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: 11696644 MAIL ADDRESS: STREET 1: 3400 CENTRAL AVENUE CITY: SANTA CLARA STATE: CA ZIP: 95051 4 1 rrd305932.xml GRANT 3-15-11 X0303 4 2011-03-15 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 2011-03-15 4 A 0 7500 0 A 27166 D Common Stock Options 5.49 2011-03-15 4 A 0 20000 0 A 2021-03-14 Common Stock 20000 20000 D Performance Accelerated Restricted Shares of Common Stock (PARS), subject to forfeiture and vesting in a single installment on March 15, 2014, 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 to forfeiture and vesting on March 15, 2014, 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. The options first become exercisable as follows: 6,667 shares on 3/15/12, 6,667 shares on 3/15/13 and 6,666 shares on 3/15/14. /s/Charles Kaufman as attorney-in-fact for Donald L. Fagen 2011-03-17