0001181431-12-014912.txt : 20120306 0001181431-12-014912.hdr.sgml : 20120306 20120306185352 ACCESSION NUMBER: 0001181431-12-014912 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120302 FILED AS OF DATE: 20120306 DATE AS OF CHANGE: 20120306 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FAGEN DONALD L CENTRAL INDEX KEY: 0001206975 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-11634 FILM NUMBER: 12672017 MAIL ADDRESS: STREET 1: 3400 CENTRAL AVENUE CITY: SANTA CLARA STATE: CA ZIP: 95051 4 1 rrd337416.xml DON FAGEN RESTRICTED STOCK TAX SALE X0304 4 2012-03-02 0 0000718937 STAAR SURGICAL CO STAA 0001206975 FAGEN DONALD L 1911 WALKER AVE MONROVIA CA 91016 0 1 0 0 V.P. Sales for N. America Common Stock 2012-03-02 4 S 0 100 10.94 D 10400 D Common Stock 2012-03-02 4 S 0 100 10.95 D 10300 D Common Stock 2012-03-02 4 S 0 100 10.99 D 10200 D Common Stock 2012-03-02 4 S 0 200 11.00 D 10000 D Common Stock 2012-03-02 4 S 0 200 11.01 D 9800 D Common Stock 2012-03-02 4 S 0 100 11.02 D 9700 D Common Stock 2012-03-02 4 S 0 200 11.04 D 9500 D Common Stock 2012-03-02 4 S 0 100 11.09 D 9400 D Common Stock 2012-03-02 4 S 0 100 11.15 D 9300 D Includes 7,500 Performance Accelerated Restricted Shares (PARS), subject to forfeiture and vesting in a single installment on March 15, 2014, but subject to accelerated vesting as to 1/3 of the shares each year pursuant to achievement of certain performance criteria. Following all reported transactions, Mr. Fagen's total beneficial ownership (as defined in Rule 13d-3 under the Exchange Act) is 49,299 shares of Common Stock, which includes 7,500 PARS and 39,999 options that have vested or will vest within 60 days of this report. As of the completion of the reported transactions he also held 30,001 unvested stock options. This Statement on Form 4 reports Mr. Fagen's sale of 1,200 shares of STAAR Common Stock on March 2, 2012 pursuant to a trading plan under Rule 10b5-1 entered into on December 4, 2011, for the purpose of paying withholding taxes that arise on the vesting of restricted shares. /s/Charles Kaufman as attorney-in-fact for Donald L. Fagen 2012-03-06