Exhibit (a)(1)(F)
IRIDEX Corporation
Receipt for Hand Delivery
of Election Form
Stock Option Exchange Offer
Commencing on July 30, 2009 and Expiring on August 27, 2009,
at 5:00 p.m., Pacific Daylight Time (unless the offer is extended)
Employee Name: hand delivered to Susan Bruce the required Election Form to participate in the 2009 Stock Option Exchange Offer.
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| Signature: Susan Bruce |