STAAR SURGICAL CO — Director's Dealing 2017

Apr 28, 2017

SEC Form 3 — Initial Statement of Beneficial Ownership

Issuer: STAAR SURGICAL CO (STAA)
CIK: 0000718937
Period of Report: 2017-04-28

Reporting Person: ANDREWS DEBORAH J (Vice President, Interim CFO)

Holdings (Non-Derivative)

Security	Shares	Ownership
Common Stock	3500	Direct

Holdings (Derivative)

Security	Exercise Price	Expiration	Underlying	Shares	Ownership
Common Stock Options	$2.91	2018-05-14	Common Stock (20000)		Direct
Common Stock Options	$5.68	2020-12-14	Common Stock (25000)		Direct
Common Stock Options	$5.49	2021-03-04	Common Stock (20000)		Direct
Common Stock Options	$11.00	2022-03-01	Common Stock (20000)		Direct
Common Stock Options	$5.34	2023-03-03	Common Stock (20000)		Direct
Common Stock Options	$15.54	2024-03-06	Common Stock (10000)		Direct
Common Stock Options	$7.35	2025-04-06	Common Stock (15000)		Direct
Common Stock Options	$7.36	2026-04-03	Common Stock (9000)		Direct
Common Stock Options	$9.30	2027-03-20	Common Stock (5000)		Direct

Footnotes

F1: Includes an award of 2,500 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.

F2: One third of the options vested on this date upon the completion of 12 months of continuous employment from the date of grant and thereafter, the balance vested in increments of one third on the following two anniversaries of the grant date.

F3: The options granted become exercisable as follows: 1/3 upon completion of 12 months continuous employment from the date of grant and the remaining 2/3 of such options shall become exercisable over the next 24 months in equal amounts on a monthly basis, subject to continuous employment.