0001181431-11-047221.txt : 20110826 0001181431-11-047221.hdr.sgml : 20110826 20110826193547 ACCESSION NUMBER: 0001181431-11-047221 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110826 FILED AS OF DATE: 20110826 DATE AS OF CHANGE: 20110826 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Caldwell Barry G CENTRAL INDEX KEY: 0001332314 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-11634 FILM NUMBER: 111061245 MAIL ADDRESS: STREET 1: 1212 TERRA BELLA AVENUE CITY: MOUNTAIN VIEW STATE: CA ZIP: 94043 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 rrd320795.xml FORM 4 B CALDWELL X0304 4 2011-08-26 0 0000718937 STAAR SURGICAL CO STAA 0001332314 Caldwell Barry G 1911 WALKER AVE MONROVIA CA 91016 1 1 0 0 President and CEO Common Stock 2011-08-26 4 S 0 10000 8.05 D 221839 D Following the reported transaction Mr. Caldwell's total beneficial ownership (as defined in Rule 13d-3 under the Exchange Act) is 441,839 shares of Common Stock, which includes 220,000 vested stock options, 10,000 restricted shares and 15,000 performance accelerated restricted shares. He also holds 90,000 unvested stock options. /s/Charles Kaufman as attorney-in-fact for Barry G. Caldwell 2011-08-26