0001209191-19-058128.txt : 20191126 0001209191-19-058128.hdr.sgml : 20191126 20191126163320 ACCESSION NUMBER: 0001209191-19-058128 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20191125 FILED AS OF DATE: 20191126 DATE AS OF CHANGE: 20191126 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Moore John C CENTRAL INDEX KEY: 0001426569 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-11634 FILM NUMBER: 191251469 MAIL ADDRESS: STREET 1: 1911 WALKER AVE CITY: MONROVIA STATE: CA ZIP: 91016 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: 0103 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 doc4.xml FORM 4 SUBMISSION X0306 4 2019-11-25 0 0000718937 STAAR SURGICAL CO STAA 0001426569 Moore John C 25651 ATLANTIC OCEAN DRIVE LAKE FOREST CA 92630 1 0 0 0 Common Stock 2019-11-25 4 M 0 20000 4.73 A 65035 D Common Stock 2019-11-25 4 M 0 8613 38.54 D 56422 D Common Stock 92296 I By Family Trust Common Stock Options 4.73 2019-11-25 4 M 0 20000 0.00 D 2011-05-19 2020-05-18 Common Stock 20000 0 D The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $38.50 to $38.61, inclusive. Shares allocated to reporting person's family trust. This Form 4 reflects the exercise of stock options set to expire in May 2020. Mr. Moore sold shares to pay the strike price and to cover the tax obligations resulting from the stock option exercise. Mr. Moore elected to hold the remaining shares from the stock option exercise. /s/ Samuel Gesten as attorney-in-fact for Mr. John C. Moore 2019-11-26