SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
  
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
BROADWOOD PARTNERS, L.P.

(Last) (First) (Middle)
C/O BROADWOOD CAPITAL INC.
142 WEST 57TH STREET, 11TH FLOOR

(Street)
NEW YORK NY 10019

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
STAAR SURGICAL CO [ STAA ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
06/24/2021
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 06/24/2021 S 67,708 D $157.83(2) 8,824,974 D(1)
Common Stock 06/24/2021 S 0 D $0 8,824,974 I Footnote(1)
Common Stock 06/25/2021 S 30,735 D $155.84(3) 8,794,239 D(1)
Common Stock 06/25/2021 S 0 D $0 8,794,239 I Footnote(1)
Common Stock 06/28/2021 S 130,000 D $155.19(4) 8,664,239 D(1)
Common Stock 06/28/2021 S 0 D $0 8,664,239 I Footnote(1)
Common Stock 25,900 D(5)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
1. Name and Address of Reporting Person*
BROADWOOD PARTNERS, L.P.

(Last) (First) (Middle)
C/O BROADWOOD CAPITAL INC.
142 WEST 57TH STREET, 11TH FLOOR

(Street)
NEW YORK NY 10019

(City) (State) (Zip)
1. Name and Address of Reporting Person*
BRADSHER NEAL C

(Last) (First) (Middle)
C/O BROADWOOD CAPITAL INC.
142 WEST 57TH STREET, 11TH FLOOR

(Street)
NEW YORK NY 10019

(City) (State) (Zip)
1. Name and Address of Reporting Person*
BROADWOOD CAPITAL INC

(Last) (First) (Middle)
142 WEST 57TH STREET, 11TH FLOOR

(Street)
NEW YORK NY 10019

(City) (State) (Zip)
Explanation of Responses:
1. The reported securities are directly owned by Broadwood Partners, L.P. ("Broadwood Partners") and may be deemed beneficially owned by Broadwood Capital, Inc. as General Partner of Broadwood Partners and Neal C. Bradsher as President of Broadwood Capital, Inc. Each Reporting Person disclaims beneficial ownership of the reported securities except to the extent of his or its pecuniary interest therein, and this report shall not be deemed an admission that such Reporting Person is the beneficial owner of the securities for purposes of Section 16 of the Securities Exchange Act of 1934, as amended, or for any other purpose.
2. This constitutes the weighted average sale price. The prices range from $154.96 to $161.57. The Reporting Persons will provide upon request by the Securities and Exchange Commission staff (the "SEC Staff"), the issuer or a security holder of the issuer, full information regarding the number of shares sold at each separate price.
3. This constitutes the weighted average sale price. The prices range from $155.03 to $157.67. The Reporting Persons will provide upon request by the SEC Staff, the issuer or a security holder of the issuer, full information regarding the number of shares sold at each separate price.
4. This constitutes the weighted average sale price. The prices range from $155.01 to $158.51. The Reporting Persons will provide upon request by the SEC Staff, the issuer or a security holder of the issuer, full information regarding the number of shares sold at each separate price.
5. These securities are directly owned by Neal C. Bradsher.
Broadwood Partners, L.P., By: Broadwood Capital, Inc., By: /s/ Neal C. Bradsher, President 06/28/2021
Neal C. Bradsher, /s/ Neal C. Bradsher 06/28/2021
Broadwood Capital, Inc., By: /s/ Neal C. Bradsher, President 06/28/2021
** 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 4 (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.