Form 3 VARIAN MEDICAL SYSTEMS For: Aug 20 Filed by: BRUNER JUDY
FREE Breaking News Alerts from StreetInsider.com!
StreetInsider.com Top Tickers, 4/25/2024
August 25, 2016 5:19 PM EDT
| FORM
3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF
SECURITIES
Filed pursuant to Section 16(a) of the
Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act
of 1940
|
| OMB APPROVAL |
| OMB Number: |
3235-0104 |
| Expires: |
December 31, 2014 |
| Estimated average burden |
| hours per response: |
0.5 |
|
|
1. Name and Address of Reporting Person
*
| C/O VARIAN MEDICAL SYSTEMS, INC. |
| 3100 HANSEN WAY, MAIL STOP E-327 |
(Street)
|
2. Date of Event Requiring Statement
(Month/Day/Year)
08/20/2016
|
3. Issuer Name
and
Ticker or Trading Symbol
VARIAN MEDICAL SYSTEMS INC
[
VAR
]
|
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
| X |
Director |
|
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
5. If Amendment, Date of Original Filed
(Month/Day/Year)
|
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 Beneficially Owned |
|---|
| 1. Title of Security (Instr.
4)
|
2.
Amount of Securities Beneficially Owned (Instr.
4)
|
3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
|
4. Nature of Indirect Beneficial Ownership (Instr.
5)
|
|
No securities beneficially owned
|
0
|
D
|
|
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
|
|---|
| 1. Title of Derivative Security (Instr.
4)
|
2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
|
4. Conversion or Exercise Price of Derivative Security
|
5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
|
6. Nature of Indirect Beneficial Ownership (Instr.
5)
|
| Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
| Explanation of Responses: |
|
/s/ Franco N. Palomba, attorney-in-fact for Judy Bruner |
08/24/2016 |
|
** Signature of Reporting Person |
Date |
| Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
| * If the form is filed by more than one reporting person,
see
Instruction
4
(b)(v). |
| ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
| Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure. |
| 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 Number. |
Power of Attorney
I, Judy Bruner, hereby constitute and appoint
Elisha W. Finney, Franco N. Palomba, John W. Kuo,
Kimberley E. Honeysett, 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 20th day of July, 2016 at
Saratoga, California.
/s/ Judy Bruner
_________________
Judy Bruner
Tweet
Share
E-mail
