0001209191-23-018057.txt : 20230310 0001209191-23-018057.hdr.sgml : 20230310 20230310213610 ACCESSION NUMBER: 0001209191-23-018057 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230310 FILED AS OF DATE: 20230310 DATE AS OF CHANGE: 20230310 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Holliday Keith CENTRAL INDEX KEY: 0001678691 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-11634 FILM NUMBER: 23725474 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: 1230 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 2023-03-10 0 0000718937 STAAR SURGICAL CO STAA 0001678691 Holliday Keith 25651 ATLANTIC OCEAN DRIVE LAKE FOREST CA 92630 0 1 0 0 Chief Technology Officer Common Stock 2023-03-10 4 F 0 284 56.63 D 18264 D Common Stock 2023-03-10 4 M 0 10192 0.00 A 28456 D Common Stock Options 56.63 2023-03-10 4 M 0 18638 0.00 A 2024-03-10 2033-03-09 Common Stock 18638 18638 D Award of 10192 Restricted Stock Units of Common Stock (RSU), subject to forfeiture rights, which lapse as to 1/3 of the RSUs on 3/10/2024, 1/3 of the RSUs on 3/10/2025, and the remaining 1/3 of the RSUs on 3/10/2026. The options granted become exercisable as follows: 1/3 on 3/10/2024 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 3/10/2026. /s/ Samuel Gesten as attorney-in-fact for Keith Holliday. 2023-03-10