0001209191-17-022061.txt : 20170321 0001209191-17-022061.hdr.sgml : 20170321 20170321164521 ACCESSION NUMBER: 0001209191-17-022061 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170321 FILED AS OF DATE: 20170321 DATE AS OF CHANGE: 20170321 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: 1228 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: Blickensdoerfer Hans-Martin CENTRAL INDEX KEY: 0001488891 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-11634 FILM NUMBER: 17704643 MAIL ADDRESS: STREET 1: 1911 WALKER AVENUE CITY: MONROVIA STATE: CA ZIP: 91016 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2017-03-21 0 0000718937 STAAR SURGICAL CO STAA 0001488891 Blickensdoerfer Hans-Martin 1911 WALKER AVENUE MONROVIA CA 91016 0 1 0 0 Sr. VP, EMEA, LA and China Common Stock 2017-03-21 4 A 0 11250 0.00 A 139200 D Common Stock Options 9.30 2017-03-21 4 A 0 22500 0.00 A 2018-03-21 2027-03-20 Common Stock 22500 22500 D Award of 11,250 Restricted Stock Units of Common Stock (RSU), subject to forfeiture rights, which lapse as to 1/3 of the RSUs on 3/21/18, 1/3 of the RSUs on 3/21/19, and 1/3 of the RSUs on 3/21/20. The options granted become exercisable as follows: 1/3 on 3/21/2018 and the remaining 2/3 of such options shall become exercisable over the following 24 months in equal amounts on a monthly basis. In the event the options do not evenly divide into 24 months, the remaining balance of options granted shall become exercisable on 3/21/2020. /s/ Samuel Gesten as attorney-in-fact for Hans Blickensdoerfer 2017-03-21