SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Robins Daniel Wayne

(Last) (First) (Middle)
16509 FALLBROOK DRIVE

(Street)
FARMINGTON MN 55024

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
06/19/2009
3. Issuer Name and Ticker or Trading Symbol
TLC VISION CORP [ TLCV ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
VP Access Operations
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Shares (ESPP) 261.2337 D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Options (1) 01/02/2008(1) Common Shares 10,000 $1.16 D
Stock Options (2) 12/15/2008(2) Common Shares 4,000 $6.1 D
Stock Options (3) 01/01/2009(3) Common Shares 500 $6.63 D
Stock Options (4) 12/13/2009 Common Shares 6,000 $10.42 D
Stock Options (5) 01/03/2011 Common Shares 15,000 $6.45 D
Stock Options (6) 12/11/2013 Common Shares 11,000 $4.66 D
Stock Options (7) 12/28/2014 Common Shares 15,000 $3.04 D
Stock Options (8) 12/10/2015 Common Shares 25,000 $0.2 D
Explanation of Responses:
1. The option grants vest in four annual installments beginning January 2, 2004. The option grants have yet to expire due to material blackout.
2. The option grants vest in four annual installments beginning December 15, 2004. The option grants have yet to expire due to material blackout.
3. The option grants vest in four equal annual installments beginning January 1, 2005. The option grants have yet to expire due to material blackout.
4. The option grants vest in four equal annual installments beginning December 13, 2005.
5. The option grants vest in four equal annual installments beginning January 3, 2007.
6. The option grants vest in four equal annual installments beginning December 11, 2007.
7. The option grants vest in four equal annual installments beginning December 28, 2008.
8. The option grants vest in four equal annual installments beginning December 10, 2009.
Daniel Wayne Robins 07/22/2009
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.