0001181431-11-029439.txt : 20110512 0001181431-11-029439.hdr.sgml : 20110512 20110512192201 ACCESSION NUMBER: 0001181431-11-029439 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110510 FILED AS OF DATE: 20110512 DATE AS OF CHANGE: 20110512 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Moore John C CENTRAL INDEX KEY: 0001426569 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-11634 FILM NUMBER: 11837343 MAIL ADDRESS: STREET 1: 1911 WALKER AVE 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 rrd311527.xml J MOORE FORM 4 X0303 4 2011-05-10 0 0000718937 STAAR SURGICAL CO STAA 0001426569 Moore John C 1911 WALKER AVE MONROVIA CA 91016 1 0 0 0 Common Stock 2011-05-10 4 M 0 20000 2.91 A 67500 D Common Stock 10000 I By Trust Common Stock Options 2.91 2011-05-10 4 M 0 20000 0 D 2009-05-15 2018-05-14 Common Stock 20000 0 D Includes 47,500 shares of common stock purchasable pursuant to options currently exercisable or exercisable within 60 days of the date of this report. The shares are held by The Moore Family Trust, John C.and Madeline M. Moore, trustees. /s/Charles Kaufman, attorney-in-fact 2011-05-12