0001209191-21-034877.txt : 20210521 0001209191-21-034877.hdr.sgml : 20210521 20210521160553 ACCESSION NUMBER: 0001209191-21-034877 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210521 FILED AS OF DATE: 20210521 DATE AS OF CHANGE: 20210521 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: 21949002 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: 0101 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 2021-05-21 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 2021-05-21 4 M 0 2500 16.15 A 25826 D Common Stock 2021-05-21 4 M 0 2229 35.98 A 28055 D Common Stock 2021-05-21 4 M 0 7566 27.53 A 35621 D Common Stock 2021-05-21 4 D 0 12295 126.05 D 23326 D Common Stock Options 16.15 2021-05-21 4 M 0 2500 0.00 D 2019-03-15 2028-03-14 Common Stock 2500 5200 D Common Stock Options 35.98 2021-05-21 4 M 0 2229 0.00 D 2020-03-14 2029-03-13 Common Stock 2229 9157 D Common Stock Options 27.53 2021-05-21 4 M 0 7566 0.00 D 2021-03-20 2030-03-19 Common Stock 7566 11891 D The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $126.00 to $126.36, inclusive. The options granted become exercisable as follows: 1/3 on 3/14/2020 and the remaining 2/3 of such options shall become exercisable over the following 24 months in equal amounts on a monthly basis. In the event the options do not evenly divide into 24 months, the remaining balance of options granted shall become exercisable on 3/14/2022. The options granted become exercisable as follows: 1/3 on 3/20/2021 and the remaining 2/3 of such options shall become exercisable over the following 24 months in equal amounts on a monthly basis. In the event the options do not evenly divide into 24 months, the remaining balance of options granted shall become exercisable on 3/20/2023. /s/ Samuel Gesten as attorney-in-fact for Scott Barnes 2021-05-21