0001209191-21-054675.txt : 20210903 0001209191-21-054675.hdr.sgml : 20210903 20210903130235 ACCESSION NUMBER: 0001209191-21-054675 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210901 FILED AS OF DATE: 20210903 DATE AS OF CHANGE: 20210903 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: 211235846 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: 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 2021-09-01 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 2021-09-01 4 S 0 8621 157.61 D 99760 D Common Stock 2021-09-01 4 M 0 17573 16.15 A 117333 D Common Stock 2021-09-01 4 S 0 17573 157.61 D 99760 D Common Stock 2021-09-02 4 S 0 11038 157.50 D 88722 D Common Stock 2021-09-02 4 M 0 871 16.15 A 89593 D Common Stock 2021-09-02 4 M 0 13484 29.80 A 103077 D Common Stock 2021-09-02 4 M 0 2988 35.98 A 106065 D Common Stock 2021-09-02 4 S 0 17343 157.50 D 88722 D Common Stock Options 16.15 2021-09-01 4 M 0 17573 0.00 D 2019-03-15 2028-03-14 Common Stock 17573 871 D Common Stock Options 16.15 2021-09-02 4 M 0 871 0.00 D 2019-03-15 2028-03-14 Common Stock 871 0 D Common Stock Options 29.80 2021-09-02 4 M 0 13484 0.00 D 2019-06-14 2028-06-13 Common Stock 13484 0 D Common Stock Options 35.98 2021-09-02 4 M 0 2988 0.00 D 2020-03-14 2029-03-13 Common Stock 2988 18140 D The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $157.50 to $157.99, inclusive. The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $157.50 to $157.99, inclusive. The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $157.50 to $157.56, inclusive. The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $157.50 to $157.72, 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 3/13/2029. /s/ Samuel Gesten as attorney-in-fact for Hans Blickensdoerfer 2021-09-03