Initial Statement of Beneficial Ownership (3)
September 01 2016 - 04:44PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
Estimated average burden
hours per response...
0.5
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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
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APPIO THOMAS
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2. Date of Event Requiring Statement (MM/DD/YYYY)
8/17/2016
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3. Issuer Name
and
Ticker or Trading Symbol
Valeant Pharmaceuticals International, Inc. [VRX]
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(Last)
(First)
(Middle)
400 SOMERSET CORPORATE BOULEVARD
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4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director
_____ 10% Owner
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X
___ Officer (give title below)
_____ Other (specify below)
EVP, COMPANY GROUP CHAIRMAN /
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(Street)
BRIDGEWATER, NJ 08807
(City)
(State)
(Zip)
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5. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
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X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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1.Title of Security
(Instr. 4)
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2. Amount of Securities Beneficially Owned
(Instr. 4)
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3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5)
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4. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Common Stock, no par value
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47545
(1)
(2)
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D
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 4)
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2. Date Exercisable and Expiration Date
(MM/DD/YYYY)
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3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5)
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6. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Non-Qualified Stock Options (right to purchase)
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(3)
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8/9/2023
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Common Shares, no par value
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22350
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$101.68
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D
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Explanation of Responses:
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(
1)
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Includes the maximum number of common shares, no par value ("Common Shares"), of Valeant Pharmaceuticals International, Inc. ("Valeant"), that may be delivered in settlement of 8,475 Restricted Share Units ("RSUs") granted on 8/9/2013, subject to performance-based vesting criteria as described in note (2), and 12,230 RSUs granted on 11/9/2015 subject to continued service with a vesting date of 5/9/2017.
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(
2)
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Each performance-based RSU represents a contingent right to receive up to three Common Shares on the achievement of 10 per cent, 20 per cent, and 30 per cent compounded annual share price appreciation (TSR) over a base price of $93.39 on each of the three measurement dates: 25% would vest on 5/9/2016, 50% on 8/9/2016 and 25% on 11/9/2016 (the "Original Vesting Dates"), with early vesting possible at higher TSR levels. If the RSUs do not vest on the Original Vesting Dates, they may become vested on 5/9/2017, 8/9/2017 and 11/9/2017, respectively. At the time of filing, none of these units have vested.
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(
3)
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The options were granted on 8/9/2013 and vest in equal installments on each of the first four anniversaries of the date of grant.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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APPIO THOMAS
400 SOMERSET CORPORATE BOULEVARD
BRIDGEWATER, NJ 08807
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EVP, COMPANY GROUP CHAIRMAN
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Signatures
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Kelly Webber for Thomas Appio
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9/1/2016
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 5(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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 control number.
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