0001209191-19-027085.txt : 20190502
0001209191-19-027085.hdr.sgml : 20190502
20190502180851
ACCESSION NUMBER: 0001209191-19-027085
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20190423
FILED AS OF DATE: 20190502
DATE AS OF CHANGE: 20190502
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Shuda Scott
CENTRAL INDEX KEY: 0001486636
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-27598
FILM NUMBER: 19793434
MAIL ADDRESS:
STREET 1: 402 RAILROAD AVENUE, SUITE 201
CITY: DANVILLE
STATE: CA
ZIP: 94526
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: IRIDEX CORP
CENTRAL INDEX KEY: 0001006045
STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845]
IRS NUMBER: 770210467
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1229
BUSINESS ADDRESS:
STREET 1: 1212 TERRA BELLA AVE
CITY: MOUNTAIN VIEW
STATE: CA
ZIP: 94043
BUSINESS PHONE: 6509404700
MAIL ADDRESS:
STREET 1: 1212 TERRA BELLA AVENUE
CITY: MOUNTAIN VIEW
STATE: CA
ZIP: 94043
3
1
doc3.xml
FORM 3 SUBMISSION
X0206
3
2019-04-23
0
0001006045
IRIDEX CORP
IRIX
0001486636
Shuda Scott
1212 TERRA BELLA AVENUE
MOUNTAIN VIEW
CA
94043
1
0
0
0
Common Stock
5000
D
/s/ Nilo De Castro, Attorney-in-Fact for Scott Shuda
2019-05-02
EX-24.3_850156
2
poa.txt
POA DOCUMENT
LIMITED POWER OF ATTORNEY FOR
SECTION 16 REPORTING OBLIGATIONS
The undersigned, as a Section 16 reporting person of IRIDEX Corporation (the
"Company"), hereby constitutes and appoints Nilo De Castro and Romeo Dizon, the
undersigned's true and lawful attorneys-in-fact to: complete and execute Forms
3, 4 and 5 and other forms and all amendments thereto as such attorneys-in-fact
shall in his or her discretion determine to be required or advisable pursuant to
Section 16 of the Securities Exchange Act of 1934 (as amended) and the rules and
regulations promulgated thereunder, or any successor laws and regulations, as a
consequence of the undersigned's ownership, acquisition or disposition of
securities of the Company; and do all acts necessary in order to file such forms
with the Securities and Exchange Commission, any securities exchange or national
association, the Company and such other person or agency as the attorney-in-fact
shall deem appropriate.
The undersigned hereby ratifies and confirms all that said
attorneys-in-fact and agents shall do or cause to be done by virtue hereof. The
undersigned acknowledges that the foregoing attorneys-in-fact, in serving in
such capacity at the request of the undersigned, are not assuming, nor is the
Company assuming, any of the undersigned's responsibilities to comply with
Section 16 of the Securities Exchange Act of 1934 (as amended).
This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4, and 5 with respect to the
undersigned's holdings of and transactions in securities issued by the Company,
unless earlier revoked by the undersigned in a signed writing delivered to the
Company and the foregoing attorneys-in-fact.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of this day, May 1, 2019.
/s/ Scott Shuda
_________________________________
Signature
Scott Shuda
_________________________________
Print Name