0001209191-19-041750.txt : 20190710
0001209191-19-041750.hdr.sgml : 20190710
20190710192215
ACCESSION NUMBER: 0001209191-19-041750
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20190627
FILED AS OF DATE: 20190710
DATE AS OF CHANGE: 20190710
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Hayashida Jon K.
CENTRAL INDEX KEY: 0001781825
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-11634
FILM NUMBER: 19950207
MAIL ADDRESS:
STREET 1: 25651 ATLANTIC OCEAN DRIVE
CITY: LAKE FOREST
STATE: CA
ZIP: 92630
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: 0103
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
doc3.xml
FORM 3 SUBMISSION
X0206
3
2019-06-27
0
0000718937
STAAR SURGICAL CO
STAA
0001781825
Hayashida Jon K.
25651 ATLANTIC OCEAN DRIVE
LAKE FOREST
CA
92630
0
1
0
0
VP, Global Clinical, Medical
Common Stock
21323
D
Common Stock Options
8.64
2016-07-27
2025-07-26
Common Stock Options
50000
D
Common Stock Options
7.52
2017-03-18
2026-03-17
Common Stock Options
25000
D
Common Stock Options
9.30
2018-03-21
2027-03-20
Common Stock Options
37500
D
Common Stock Options
16.15
2019-03-15
2028-03-14
Common Stock Options
25000
D
Common Stock Options
29.80
2019-06-14
2028-06-13
Common Stock Options
13484
D
Common Stock Options
35.98
2020-03-14
2029-03-13
Common Stock Options
28026
D
Includes 6,250 Restricted Stock Units of Common Stock (RSU), subject to forfeiture rights, which lapse on March 21, 2020.
The options granted became exercisable as follows: 1/3 upon completion of 12 months continuous employment from the date of grant (7/27/2015) and the remaining 2/3 vested in thirds on the following two anniversaries of the grant date, subject to continuous employment.
The options granted became exercisable as follows: 1/3 upon completion of 12 months continuous employment from the date of grant (3/18/2016) and the remaining 2/3 of such options became exercisable over the following 24 months in equal amounts on a monthly basis, subject to continuous employment.
The options granted become exercisable as follows: 1/3 upon completion of 12 months continuous employment from the date of grant (3/21/2017) and the remaining 2/3 of such options become exercisable over the following 24 months in equal amounts on a monthly basis, subject to continuous employment.
The options granted become exercisable as follows: 1/3 upon completion of 12 months continuous employment from the date of grant (3/15/2018) and the remaining 2/3 of such options become exercisable over the following 24 months in equal amounts on a monthly basis, subject to continuous employment.
The options granted become exercisable as follows: 1/3 upon completion of 12 months continuous employment from the date of grant (6/14/2018) and the remaining 2/3 of such options become exercisable over the following 24 months in equal amounts on a monthly basis, subject to continuous employment.
The options granted become exercisable as follows: 1/3 upon completion of 12 months continuous employment from the date of grant (3/14/2019) and the remaining 2/3 of such options become exercisable over the following 24 months in equal amounts on a monthly basis, subject to continuous employment.
/s/ Samuel Gesten as attorney-in-fact for Jon Hayashida
2019-07-10
EX-24.3_864703
2
poa.txt
POA DOCUMENT
LIMITED POWER OF ATTORNEY FOR
SECTION 16 REPORTING OBLIGATIONS
Know all by these presents, that the undersigned's hereby makes, constitutes
and appoints Samuel Gesten and Deborah Andrews as the undersigned's true and
lawful attorneys-in-fact, with full power and authority as hereinafter described
on behalf of and in the name, place and stead of the undersigned to:
(1) prepare, execute, acknowledge, deliver and file Forms 3, 4, and 5 (including
any amendments thereto) with respect to the securities of STAAR Surgical
Company, a Delaware corporation (the "Company"), with the United States
Securities and Exchange Commission, any national securities exchanges and the
Company, as considered necessary or advisable under Section 16(a) of the
Securities Exchange Act of 1934 and the rules and regulations promulgated
thereunder, as amended from time to time (the "Exchange Act");
(2) seek or obtain, as the undersigned's representative and on the undersigned's
behalf, information on transactions in the Company's securities from any third
party, including brokers, employee benefit plan administrators and trustees, and
the undersigned hereby authorizes any such person to release any such
information to the undersigned and approves and ratifies any such release of
information; and
(3) perform any and all other acts which in the discretion of such
attorneys-in-fact are necessary or desirable for and on behalf of the
undersigned in connection with the foregoing.
The undersigned acknowledges that:
(1) this Power of Attorney authorizes, but does not require, such
attorneys-in-fact to act in their discretion on information provided to such
attorney-in-fact without independent verification of such information;
(2) any documents prepared and/or executed by such attorneys-in-fact on behalf
of the undersigned pursuant to this Power of Attorney will be in such form and
will contain such information and disclosure as such attorneys-in-fact, in his
or her discretion, deems necessary or desirable;
(3) neither the Company nor such attornesy-in-fact assumes (i) any liability for
the undersigned's responsibility to comply with the requirement of the Exchange
Act, (ii) any liability of the undersigned for any failure to comply with such
requirements, or (iii) any obligation or liability of the undersigned for profit
disgorgement under Section 16(b) of the Exchange Act; and
(4) this Power of Attorney does not relieve the undersigned from responsibility
for compliance with the undersigned's obligations under the Exchange Act,
including without limitation the reporting requirements under Section 16 of the
Exchange Act.
The undersigned hereby gives and grants the foregoing attorneys-in-fact full
power and authority to do and perform all and every act and thing whatsoever
requisite, necessary or appropriate to be done in and about the foregoing
matters as fully to all intents and purposes as the undersigned might or could
do if present, hereby ratifying all that such attorney-in-fact of, for and on
behalf of the undersigned, shall lawfully do or cause to be done by virtue of
this Limited Power of Attorney.
This Power of Attorney shall remain in full force and effect until revoked by
the undersigned in a signed writing delivered to such attorney-in-fact.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of this 1st day of July, 2019.
/s/ Jon Hayashida
_________________________________
Signature
Jon Hayashida
_________________________________
Print Name