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