0001181431-13-015181.txt : 20130306
0001181431-13-015181.hdr.sgml : 20130306
20130306215634
ACCESSION NUMBER: 0001181431-13-015181
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20130304
FILED AS OF DATE: 20130306
DATE AS OF CHANGE: 20130306
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Blickensdoerfer Hans-Martin
CENTRAL INDEX KEY: 0001488891
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-11634
FILM NUMBER: 13671444
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
rrd373270.xml
HM BLICKENSDOERFER ANNUAL GRANT
X0306
4
2013-03-04
0
0000718937
STAAR SURGICAL CO
STAA
0001488891
Blickensdoerfer Hans-Martin
1911 WALKER AVENUE
MONROVIA
CA
91016
0
1
0
0
VP, International Marketing
Common Stock
2013-03-04
4
A
0
7500
0
A
85700
D
Common Stock Options
5.34
2013-03-04
4
A
0
20000
0
A
2023-03-04
Common Stock
20000
20000
D
Consists of 7,500 Performance Accelerated Restricted Shares of Common Stock (PARS), subject to forfeiture rights, which lapse as to all the PARS on 3/4/16, 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.
Includes 22,500 PARS.
The options first become exercisable as follows: 6,667 shares on 3/4/14, 6,666 shares on 3/4/15 and 6,666 shares on 3/4/16.
/s/Samuel Gesten as Attorney-in-Fact for Hans-Martin Blickensdoerfer
2013-03-06