0001209191-23-038169.txt : 20230616
0001209191-23-038169.hdr.sgml : 20230616
20230616203532
ACCESSION NUMBER: 0001209191-23-038169
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230615
FILED AS OF DATE: 20230616
DATE AS OF CHANGE: 20230616
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Yu K Peony
CENTRAL INDEX KEY: 0001621328
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-11634
FILM NUMBER: 231023027
MAIL ADDRESS:
STREET 1: C/O FIBROGEN, INC.
STREET 2: 409 ILLINOIS ST.,
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94158
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
X0407
4
2023-06-15
0
0000718937
STAAR SURGICAL CO
STAA
0001621328
Yu K Peony
25651 ATLANTIC OCEAN DRIVE
LAKE FOREST
CA
1
0
0
0
0
Common Stock
2023-06-15
4
M
0
1709
0.00
A
2786
D
Common Stock Options
52.67
2023-06-15
4
M
0
3127
0.00
A
2024-06-15
2034-06-14
Common Stock
3127
3127
D
The restrictions on the 1709 restricted shares of common stock lapse on the earlier of June 15, 2023 or the Corporation's 2024 Annual Meeting, subject to Dr. Yu's continued service through that date.
The options vest on the earlier of June 15, 2024 or the Corporation's 2024 Annual Shareholders Meeting, subject to her continued service through the vesting date.
/s/ Samuel Gesten as attorney-in-fact for Dr. K. Peony Yu.
2023-06-16