0001209191-23-058370.txt : 20231212
0001209191-23-058370.hdr.sgml : 20231212
20231212183123
ACCESSION NUMBER: 0001209191-23-058370
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20231211
FILED AS OF DATE: 20231212
DATE AS OF CHANGE: 20231212
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: SISITSKY NATHANIEL
CENTRAL INDEX KEY: 0001225738
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-11634
FILM NUMBER: 231482447
MAIL ADDRESS:
STREET 1: C/O CAREFUSION CORPORATION
STREET 2: 3750 TORREY VIEW COURT
CITY: SAN DIEGO
STATE: CA
ZIP: 92130
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
X0508
4
2023-12-11
0
0000718937
STAAR SURGICAL CO
STAA
0001225738
SISITSKY NATHANIEL
25651 ATLANTIC OCEAN DRIVE
LAKE FOREST
CA
0
1
0
0
General Counsel
0
Common Stock
2023-12-11
4
A
0
21935
0.00
A
21935
D
Common Stock Options
32.14
2023-12-11
4
A
0
39860
0.00
A
2024-12-11
2033-12-10
Common Stock
39860
39860
D
Award of 21935 Restricted Stock Units of Common Stock (RSU), subject to forfeiture rights, which lapse as to 1/3 of the RSUs on 12/11/2024, 1/3 of the RSUs on 12/11/2025, and the remaining 1/3 of the RSUs on 12/11/2026.
The options granted become exercisable as follows: 1/3 on 12/11/2024 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 12/11/2026.
This Form 4 reflects the equity grant to Mr. Sisitsky related to his appointment as General Counsel.
/s/ Nathaniel Sisitsky
2023-12-11