-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, R1/NeJV/d9O5OhyPYRlFlqgSdCrCPMtfsSGyZQw0CoGcgDDN+MlI6+GmhSqpURwL 9rlW86pD+dP0sXMWLMTWEA== 0001181431-04-017652.txt : 20040326 0001181431-04-017652.hdr.sgml : 20040326 20040326145646 ACCESSION NUMBER: 0001181431-04-017652 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040326 FILED AS OF DATE: 20040326 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ROEPSTORFF GUNTHER CENTRAL INDEX KEY: 0001275155 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-11634 FILM NUMBER: 04692639 BUSINESS ADDRESS: STREET 1: STAAR SURGICAL CO STREET 2: 1911 WALKER AVE CITY: MONROVIA STATE: CA ZIP: 91016 BUSINESS PHONE: 6263037902 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: STAAR SURGICAL COMPANY 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: 8183037902 MAIL ADDRESS: STREET 1: 1911 WALKER AVE CITY: MONROVIA STATE: CA ZIP: 91016 4 1 rrd37776.xml ROEPSTORFF 3/26/04 X0201 4 2004-03-26 0 0000718937 STAAR SURGICAL COMPANY STAA 0001275155 ROEPSTORFF GUNTHER 1911 WALKER AVENUE MONROVIA CA 91016 0 1 0 0 President - Domilens GmbH Common Stock Options 7.86 2004-03-26 4 A 0 8333 0 A 2005-03-26 2009-03-25 Common Stock 8333 8333 D Common Stock Options 7.86 2004-03-26 4 A 0 8333 0 A 2006-03-26 2009-03-25 Common Stock 8333 8333 D Common Stock Options 7.86 2004-03-26 4 A 0 8334 0 A 2007-03-26 2009-03-25 Common Stock 8334 8334 D Deborah Andrews as Power of Attorney for Gunther Roepstorff 2004-03-26 -----END PRIVACY-ENHANCED MESSAGE-----