SEC Form 4 · accession 0001209191-17-022061
STAAR SURGICAL CO · STAA
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Hans-Martin Blickensdoerfer
Officer — Sr. VP, EMEA, LA and China
Period of report
Mar 21, 2017
Accepted (ET)
Mar 21, 2017 · 4:45 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000718937
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Mar 21, 2017 | A | 11,250 | $0.00 | A | 139,200 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Common Stock OptionsF2 | $9.30 | Mar 21, 2017 | A | 22,500 | A | Mar 21, 2018 | Mar 20, 2027 | Common Stock | 22,500 | 22,500 | D |
Explanation of responses
- F1Award of 11,250 Restricted Stock Units of Common Stock (RSU), subject to forfeiture rights, which lapse as to 1/3 of the RSUs on 3/21/18, 1/3 of the RSUs on 3/21/19, and 1/3 of the RSUs on 3/21/20.
- F2The options granted become exercisable as follows: 1/3 on 3/21/2018 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 3/21/2020.