Statement of Changes in Beneficial Ownership (4)
2020年12月9日 - 7:33AM
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
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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
]
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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 |
(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
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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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)
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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
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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 |
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