Statement of Changes in Beneficial Ownership (4)
December 08 2020 - 05:33PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL
OWNERSHIP OF SECURITIES
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OMB
APPROVAL
OMB Number: 3235-0287
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 * MOMSEN MAGNUS |
2. Issuer Name and Ticker or Trading
Symbol VARIAN MEDICAL SYSTEMS INC [ VAR ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)_____
Director _____
10% Owner
__X__ Officer (give title
below) _____ Other
(specify below)
SVP, CAO, Corporate Controller |
(Last)
(First)
(Middle)
C/O VARIAN MEDICAL SYSTEMS, INC., 3100 HANSEN WAY, MS
E327 |
3. Date of Earliest Transaction (MM/DD/YYYY)
12/4/2020
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(Street)
PALO ALTO, CA 94304
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line) _X _ Form filed by One Reporting Person
___ 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. Trans. Date |
2A. Deemed Execution Date, if any |
3. Trans. 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 |
12/4/2020 |
|
M(1) |
|
6064 |
A |
$67.12 |
7719 |
D |
|
Common Stock |
12/4/2020 |
|
S(1) |
|
6064 |
D |
$174.4114 (2) |
1655 |
D |
|
Common Stock |
12/4/2020 |
|
M(1) |
|
8266 |
A |
$80.40 |
9921 |
D |
|
Common Stock |
12/4/2020 |
|
S(1) |
|
8266 |
D |
$174.5113 (3) |
1655 |
D |
|
Common Stock |
12/4/2020 |
|
S(1) |
|
1032 |
D |
$174.4702 (4) |
623 |
D |
|
Common Stock |
12/4/2020 |
|
S(1) |
|
547 |
D |
$174.4712 (5) |
76 |
D |
|
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible
securities)
|
1. Title of Derivate Security
(Instr. 3) |
2. Conversion or Exercise Price of Derivative
Security |
3. Trans. Date |
3A. Deemed Execution Date, if any |
4. Trans. 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 |
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 of Derivative Security: 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 |
Non Qualified Stock Option (Right to
Buy) |
$67.12 |
12/4/2020 |
|
M (1) |
|
|
6064 |
(6) |
2/12/2023 |
Common Stock |
6064 |
$0 |
0 |
D |
|
Non Qualified Stock Option (Right to
Buy) |
$80.40 |
12/4/2020 |
|
M (1) |
|
|
8266 |
(7) |
2/10/2024 |
Common Stock |
8266 |
$0 |
0 |
D |
|
Explanation of
Responses: |
(1) |
This transaction is pursuant
to the filer's SEC Rule10b5-1 Stock Plan |
(2) |
The 6,064 shares were sold
in multiple transactions executed on the same day at prices ranging
from $174.30 to $174.47. The detailed breakdown of executed sales
will be furnished upon request. |
(3) |
The 8,244 shares were sold
in multiple transactions executed on the same day at prices ranging
from $174.47 to $174.59. The detailed breakdown of executed sales
will be furnished upon request. |
(4) |
The 1,032 shares were sold
in multiple transactions executed on the same day at prices ranging
from $174.36 to $174.585. The detailed breakdown of executed sales
will be furnished upon request. |
(5) |
The 547 shares were sold in
multiple transactions executed on the same day at prices ranging
from $174.36 to $174.585. The detailed breakdown of executed sales
will be furnished upon request. |
(6) |
Stock option granted under
the Varian Medical Systems, Inc. Third Amended and Restated 2005
Omnibus Stock Plan which complies with Rule 16b-3. The option vests
as follows: one third on 2/12/2017, and the remaining shares in 24
equal installments over the 24 months following the first vesting
date. |
(7) |
Stock option granted under
the Varian Medical Systems, Inc. Fourth Amended and Restated 2005
Omnibus Stock Plan which complies with Rule 16b-3. The option vests
as follows: one third on 2/10/2018, and the remaining shares in 24
equal installments over the 24 months following the first vesting
date. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
MOMSEN MAGNUS
C/O VARIAN MEDICAL SYSTEMS, INC.
3100 HANSEN WAY, MS E327
PALO ALTO, CA 94304 |
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|
SVP, CAO, Corporate Controller |
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Signatures
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/s/ Michael B. Dunn, attorney-in-fact for Magnus
Momsen |
|
12/8/2020 |
**Signature of Reporting
Person |
Date |