0001209191-19-059482.txt : 20191206 0001209191-19-059482.hdr.sgml : 20191206 20191206163455 ACCESSION NUMBER: 0001209191-19-059482 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20191204 FILED AS OF DATE: 20191206 DATE AS OF CHANGE: 20191206 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: 191273512 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: 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 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2019-12-04 0 0000718937 STAAR SURGICAL CO STAA 0001488891 Blickensdoerfer Hans-Martin 25651 ATLANTIC OCEAN DRIVE LAKE FOREST CA 92630 0 1 0 0 Sr. VP, Comm. Ops, China Common Stock 2019-12-04 4 M 0 25000 5.68 A 149200 D Common Stock 2019-12-04 4 S 0 25000 38.15 D 124200 D Common Stock 2019-12-04 4 M 0 20000 5.49 A 144200 D Common Stock 2019-12-04 4 S 0 20000 38.15 D 124200 D Common Stock Options 5.68 2019-12-04 4 M 0 25000 0.00 D 2020-12-14 Common Stock 25000 0 D Common Stock Options 5.49 2019-12-04 4 M 0 20000 0.00 D 2021-03-14 Common Stock 20000 0 D The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $38.00 to $38.33, inclusive. The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $38.00 to $38.33, inclusive. The options vested in three equal installments on December 15, 2011, December 15, 2012, and December 15, 2013. The options vested in three equal installments on March 15, 2012, March 15, 2013, and March 15, 2014. This Form 4 reflects the exercise of stock options awarded to Mr. Blickensdoerfer in 2010 and 2011. /s/ Samuel Gesten as attorney-in-fact for Hans Blickensdoerfer 2019-12-06