0001209191-20-036240.txt : 20200612 0001209191-20-036240.hdr.sgml : 20200612 20200612160124 ACCESSION NUMBER: 0001209191-20-036240 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200610 FILED AS OF DATE: 20200612 DATE AS OF CHANGE: 20200612 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Blickensdoerfer Hans-Martin CENTRAL INDEX KEY: 0001488891 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-11634 FILM NUMBER: 20960200 MAIL ADDRESS: STREET 1: 1911 WALKER AVENUE 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 2020-06-10 0 0000718937 STAAR SURGICAL CO STAA 0001488891 Blickensdoerfer Hans-Martin 25651 ATLANTIC OCEAN DRIVE LAKE FOREST CA 92630 0 1 0 0 Sr. VP, Comm. Ops, China Common Stock 2020-06-10 4 M 0 785 11.00 A 128735 D Common Stock 2020-06-10 4 S 0 785 44.00 D 127950 D Common Stock Options 11.00 2020-06-10 4 M 0 785 0.00 D 2013-03-02 2022-03-01 Common Stock 785 19215 D The options vested in three equal installments on March 2, 2013, March 2, 2014, and March 2, 2015. This Form 4 reflects the exercise of stock options awarded to Mr. Blickensdoerfer in 2012. /s/ Samuel Gesten as attorney-in-fact for Hans Blickensdoerfer 2020-06-12