0001209191-19-019674.txt : 20190315 0001209191-19-019674.hdr.sgml : 20190315 20190315160332 ACCESSION NUMBER: 0001209191-19-019674 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190314 FILED AS OF DATE: 20190315 DATE AS OF CHANGE: 20190315 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: 19685031 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: 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 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2019-03-14 0 0000718937 STAAR SURGICAL CO STAA 0001488891 Blickensdoerfer Hans-Martin 1911 WALKER AVENUE MONROVIA CA 91016 0 1 0 0 Sr. VP, Comm. Ops, China Common Stock Options 35.98 2019-03-14 4 A 0 21128 0.00 A 2020-03-14 2029-03-13 Common Stock 21128 21128 D The options granted become exercisable as follows: 1/3 on 3/14/2020 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 3/14/2022. /s/ Samuel Gesten as attorney-in-fact for Hans Blickensdoerfer 2019-03-15