0001181431-12-023304.txt : 20120410 0001181431-12-023304.hdr.sgml : 20120410 20120410144151 ACCESSION NUMBER: 0001181431-12-023304 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120405 FILED AS OF DATE: 20120410 DATE AS OF CHANGE: 20120410 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gesten Samuel J CENTRAL INDEX KEY: 0001496615 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-11634 FILM NUMBER: 12751754 MAIL ADDRESS: STREET 1: 2525 DUPONT DRIVE CITY: IRVINE STATE: CA ZIP: 92612 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 3 1 rrd341881.xml FORM 3 - GESTEN X0205 3 2012-04-05 0 0000718937 STAAR SURGICAL CO STAA 0001496615 Gesten Samuel J 1911 WALKER AVENUE MONROVIA CA 91016 0 1 0 0 VP, General Counsel Common Stock 27500 D Common Stock Options 11.02 2022-04-01 Common Stock 50000 D Consists of (i) 20,000 restricted shares of common stock, subject to forfeiture rights, which lapse as to 1/3 of the shares each year on the anniversary of grant date, and (ii) 7,500 Performance Accelerated Restricted Shares of Common Stock (PARS), subject to forfeiture rights, which lapse as to all the PARS on 4/2/15, but subject to accelerated lapse of the forfeiture rights as to 1/3 of the shares each year pursuant to achievement of certain performance criteria. 16,666 options will vest 4/2/13, 16,667 options will vest on 4/2/14, and the remaining 16,667 shares will vest on 4/2/15. Mr. Gesten assumed the General Counsel role as of 4/5/12 and this form reports his holdings as of that date. Samuel J. Gesten 2012-04-10