0001209191-20-036240.txt : 20200612
0001209191-20-036240.hdr.sgml : 20200612
20200612160124
ACCESSION NUMBER: 0001209191-20-036240
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200610
FILED AS OF DATE: 20200612
DATE AS OF CHANGE: 20200612
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: 20960200
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
2020-06-10
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
2020-06-10
4
M
0
785
11.00
A
128735
D
Common Stock
2020-06-10
4
S
0
785
44.00
D
127950
D
Common Stock Options
11.00
2020-06-10
4
M
0
785
0.00
D
2013-03-02
2022-03-01
Common Stock
785
19215
D
The options vested in three equal installments on March 2, 2013, March 2, 2014, and March 2, 2015.
This Form 4 reflects the exercise of stock options awarded to Mr. Blickensdoerfer in 2012.
/s/ Samuel Gesten as attorney-in-fact for Hans Blickensdoerfer
2020-06-12