0001209191-21-016886.txt : 20210303 0001209191-21-016886.hdr.sgml : 20210303 20210303163725 ACCESSION NUMBER: 0001209191-21-016886 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210301 FILED AS OF DATE: 20210303 DATE AS OF CHANGE: 20210303 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hayashida Jon K. CENTRAL INDEX KEY: 0001781825 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-11634 FILM NUMBER: 21709609 MAIL ADDRESS: STREET 1: 25651 ATLANTIC OCEAN DRIVE CITY: LAKE FOREST STATE: CA ZIP: 92630 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 2021-03-01 0 0000718937 STAAR SURGICAL CO STAA 0001781825 Hayashida Jon K. 25651 ATLANTIC OCEAN DRIVE LAKE FOREST CA 92630 0 1 0 0 VP, Global Clinical, Medical Common Stock 2021-03-01 4 M 0 16000 35.98 A 26794 D Common Stock 2021-03-01 4 S 0 16000 105.43 D 10794 D Common Stock Options 35.98 2021-03-01 4 M 0 16000 0.00 D 2020-03-14 2029-03-13 Common Stock 16000 12026 D The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $102.86 to $106.19, inclusive. The options granted become exercisable as follows: 1/3 on 3/14/2020 and the remaining 2/3 of such options shall become exercisable over the following 24 months in equal amounts on a monthly basis. In the event the options do not evenly divide into 24 months, the remaining balance of options granted shall become exercisable on 3/14/2023. /s/ Samuel Gesten as attorney-in-fact for Dr. Jon Hayashida 2021-03-03