0001209191-21-020524.txt : 20210315 0001209191-21-020524.hdr.sgml : 20210315 20210315171838 ACCESSION NUMBER: 0001209191-21-020524 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210312 FILED AS OF DATE: 20210315 DATE AS OF CHANGE: 20210315 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Williams Patrick F. CENTRAL INDEX KEY: 0001562229 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-11634 FILM NUMBER: 21742531 MAIL ADDRESS: STREET 1: C/O ZELTIQ AESTHETICS INC. STREET 2: 4698 WILLOW ROAD, SUITE 100 CITY: PLEASANTON STATE: CA ZIP: 94588 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 2021-03-12 0 0000718937 STAAR SURGICAL CO STAA 0001562229 Williams Patrick F. 25651 ATLANTIC OCEAN DRIVE LAKE FOREST CA 0 1 0 0 Chief Financial Officer Common Stock 2021-03-12 4 M 0 2513 0.00 A 33240 D Common Stock Options 90.38 2021-03-12 4 M 0 5312 0.00 A 2022-03-12 2031-03-11 Common Stock 5312 5312 D Award of 2513 Restricted Stock Units of Common Stock (RSU), subject to forfeiture rights, which lapse as to 1/3 of the RSUs on 3/12/22, 1/3 of the RSUs on 3/12/23, and the remaining 1/3 of the RSUs on 3/12/24. The options granted become exercisable as follows: 1/3 on 3/12/2022 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 3/12/2024. /s/ Samuel Gesten as attorney-in-fact for Patrick F. Williams 2021-03-15