0001209191-21-021377.txt : 20210317
0001209191-21-021377.hdr.sgml : 20210317
20210317164526
ACCESSION NUMBER: 0001209191-21-021377
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210316
FILED AS OF DATE: 20210317
DATE AS OF CHANGE: 20210317
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Barnes Scott D
CENTRAL INDEX KEY: 0001781830
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-11634
FILM NUMBER: 21751118
MAIL ADDRESS:
STREET 1: 25651 ATLANTIC OCEAN DRIVE
CITY: LAKE FORST
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
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-03-16
0
0000718937
STAAR SURGICAL CO
STAA
0001781830
Barnes Scott D
25651 ATLANTIC OCEAN DRIVE
LAKE FOREST
CA
92630
0
1
0
0
Chief Medical Officer
Common Stock
2021-03-16
4
M
0
2664
15.25
A
23054
D
Common Stock
2021-03-16
4
D
0
2664
95.00
D
20390
D
Common Stock Options
15.25
2021-03-16
4
M
0
2664
0.00
D
2018-11-13
2027-11-12
Common Stock
2664
19671
D
/s/ Samuel Gesten as attorney-in-fact for Scott Barnes
2021-03-16