SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Studholme Robert

(Last) (First) (Middle)
25651 ATLANTIC OCEAN DRIVE

(Street)
LAKE FOREST CA 92630

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
03/16/2022
3. Issuer Name and Ticker or Trading Symbol
STAAR SURGICAL CO [ STAA ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Senior VP,Operations
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 20,850(1) D
Common Stock 502 I By spouse.
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Common Stock Options 03/07/2023(2) 03/07/2032 Commmon Stock 12,547 $74.8 D
Common Stock Options 03/12/2022(3) 03/12/2031 Common Stock 4,879 $90.38 D
Common Stock Options 03/20/2021(4) 03/20/2030 Common Stock 14,629 $27.53 D
Common Stock Options 03/14/2022(5) 03/14/2029 Common Stock 24,284 $35.98 D
Common Stock Options 06/14/2021(5) 06/14/2028 Common Stock 2,368 $29.8 D
Common Stock Options 03/15/2021(5) 03/14/2028 Common Stock 10,015 $16.15 D
Common Stock Options 03/21/2020(5) 03/21/2027 Common Stock 10,000 $9.3 D
Common Stock Options 04/04/2019(5) 04/04/2026 Common Stock 10,000 $7.36 D
Explanation of Responses:
1. Of these, 9,917 are restricted shares subject to forfeiture rights, of which 2,010 will vest on 03/07/2023, 769 will vest on 03/12/2023, 2,346 will vest on 03/20/2023, 2,011 will vest on 03/07/2024, 770 will vest on 03/12/2024, and 2,011 will vest on 03/07/2025.
2. The options become exercisable as follows: 1/3 on 3/7/2023 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 3/7/2025.
3. The options 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.
4. The options become exercisable as follows: 1/3 on 3/20/2021, 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 3/20/2023.
5. All options became exercisable on or before the stated date.
/s/Samuel Gesten as Attorney-in-Fact for Robert Studholme 07/05/2022
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.