0001127602-17-004060.txt : 20170206 0001127602-17-004060.hdr.sgml : 20170206 20170206161552 ACCESSION NUMBER: 0001127602-17-004060 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20170128 FILED AS OF DATE: 20170206 DATE AS OF CHANGE: 20170206 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: VARIAN MEDICAL SYSTEMS INC CENTRAL INDEX KEY: 0000203527 STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845] IRS NUMBER: 942359345 STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 BUSINESS ADDRESS: STREET 1: 3100 HANSEN WAY CITY: PALO ALTO STATE: CA ZIP: 94304-1000 BUSINESS PHONE: 650-424-5834 MAIL ADDRESS: STREET 1: 3100 HANSEN WAY CITY: PALO ALTO STATE: CA ZIP: 94304-1000 FORMER COMPANY: FORMER CONFORMED NAME: VARIAN ASSOCIATES INC /DE/ DATE OF NAME CHANGE: 19920703 FORMER COMPANY: FORMER CONFORMED NAME: VARIAN DELAWARE INC DATE OF NAME CHANGE: 19761123 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MOMSEN MAGNUS CENTRAL INDEX KEY: 0001695593 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-07598 FILM NUMBER: 17575771 MAIL ADDRESS: STREET 1: VARIAN MEDICAL SYSTEMS INC. STREET 2: 3100 HANSEN WAY MAIL STOP E327 CITY: PALO ALTO STATE: CA ZIP: 94304 3 1 form3.xml PRIMARY DOCUMENT X0206 3 2017-01-28 0 0000203527 VARIAN MEDICAL SYSTEMS INC VAR 0001695593 MOMSEN MAGNUS C/O VARIAN MEDICAL SYSTEMS, INC. 3100 HANSEN WAY, MS E327 PALO ALTO CA 94304 1 SVP, CAO, Corporate Controller Common Stock 5116 D Non Qualified Stock Option (Right to Buy) 60.91 2015-11-09 2019-11-09 Common Stock 4057 D Non Qualified Stock Option (Right to Buy) 74.06 2017-02-21 2021-02-21 Common Stock 4343 D Non Qualified Stock Option (Right to Buy) 81.97 2022-02-13 Common Stock 4473 D Non Qualified Stock Option (Right to Buy) 67.12 2023-02-12 Common Stock 6064 D Restricted Stock Units Common Stock 631 D Restricted Stock Units Common Stock 1194 D Restricted Stock Units Common Stock 2185 D 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 11/09/2013, and the remaining shares in 24 equal installments over the 24 months following the first vesting date. 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 02/21/2015, and the remaining shares in 24 equal installments over the 24 months following the first vesting date. 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 2/13/2016, and the remaining shares in 24 equal installments over the 24 months following the first vesting date. 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. The restricted stock units vest on February 15, 2017. Vested shares will be delivered to the reporting person on vest date. Each restricted stock unit represents a contingent right to receive one share of VAR common stock. The restricted stock units vest in three equal installments on February 15, 2016, February 15, 2017, and February 15, 2018. Vested shares will be delivered to the reporting person on vest date. The restricted stock units vest in three equal installments on February 15, 2017, February 15, 2018, and February 15, 2019. Vested shares will be delivered to the reporting person on vest date. The terms of each of the reporting person's outstanding options and restricted stock units were adjusted pursuant to the Employee Matters Agreement between Varian Medical Systems, Inc. ("Varian") and Varex Imaging Corporation ("Varex") relating to the January 28, 2017 distribution by Varian to its stockholders of all of the outstanding shares of the common stock of Varex. All information regarding such options and restricted stock units is shown on this Form 3 on a post-adjustment basis. /s/ Franco N. Palomba, Attorney in Fact for Magnus Momsen 2017-02-06 EX-24 2 doc1.txt POWER OF ATTORNEY (PUBLIC): POWER OF ATTORNEY Power of Attorney I, Magnus Momsen, hereby constitute and appoint John W. Kuo, Franco N. Palomba, Brian A. Pollard, Keith G. Askoff, and each of them individually, as my true and lawful attorney-in-fact to: 1. Prepare, execute in my name and on my behalf, and submit to the U.S. Securities and Exchange Commission (the "SEC") a Form ID, including amendments thereto, and any other documents necessary or appropriate to obtain codes and passwords enabling me to make electronic filings with the SEC of reports required by Section 16(a) of the Securities Exchange Act of 1934 or any rule or regulation of the SEC. 2. Complete and execute on my behalf as an officer and/or director of Varian Medical Systems, Inc. (the "Company") any Forms 3, 4, or 5, and any amendment thereto, required to be filed by me under Section 16(a) of the Securities Exchange Act of 1934 and the rules and regulations thereunder. 3. Do and perform any and all acts for and on my behalf which may be necessary or desirable to complete any such Form 3, 4 or 5, and any amendment thereto, and timely file such form or amended form with the SEC and any stock exchange or similar authority; and 4. Take any other action of any type whatsoever in connection with the foregoing, which in the opinion of such attorney-in-fact may be of benefit to, in the best interest of, or legally required of me, it being understood that the documents executed by such attorney-in-fact on my behalf pursuant to this Power of Attorney shall be in such form and shall contain such information as such attorney-in-fact may approve in such attorney-in-fact's discretion. I hereby grant to each of such attorneys-in-fact full power and authority to do and perform any and every act which is necessary or desirable to be done in the exercise of any of the powers and authority granted in this Power of Attorney, with full power of substitution and revocation, and I ratify and confirm every act that such attorney-in-fact lawfully performs or causes to be done by virtue of this Power of Attorney and the powers and authority granted herein. I acknowledge that the attorneys-in-fact appointed in this Power of Attorney, in serving in such capacity at my request, are not assuming, and the Company is not assuming, any of my responsibilities to comply with Section 16 of the Securities and Exchange Act of 1934 or the rules or regulations thereunder. This Power of Attorney shall remain in full force and effect until I am no longer required to file Forms 3, 4 or 5 with respect to my holding or transactions in securities issued by the Company, unless I earlier revoke this Power of Attorney in a signed writing delivered to the foregoing attorneys-in-fact. IN WITNESS WHEREOF, the undersigned has executed this power of attorney as of this 6th day of December, 2016 at Palo Alto, California. /s/ Magnus Momsen _________________ Magnus Momsen