SEC FORM 3 SEC Form 3
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
 
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1. Name and Address of Reporting Person*
Roman Brian

(Last) (First) (Middle)
1000 MYLAN BOULEVARD

(Street)
CANONSBURG PA 15317

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
03/01/2021
3. Issuer Name and Ticker or Trading Symbol
Viatris Inc [ VTRS ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Global General Counsel
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)
Common Stock 28,530 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
Employee Stock Option - Right to Buy (1) 03/06/2023 Common Stock 1,729 30.9 D
Employee Stock Option - Right to Buy (1) 03/06/2023 Common Stock 526 30.9 D
Employee Stock Option - Right to Buy (2) 03/05/2024 Common Stock 2,547 55.84 D
Employee Stock Option - Right to Buy (3) 03/04/2025 Common Stock 4,111 55.61 D
Employee Stock Option - Right to Buy (4) 02/17/2026 Common Stock 4,739 46.27 D
Employee Stock Option - Right to Buy (5) 03/03/2027 Common Stock 5,694 45.18 D
Employee Stock Option - Right to Buy (6) 03/02/2028 Common Stock 7,876 40.97 D
Restricted Stock Units (7) (7) Common Stock 1,611 0.00 D
Restricted Stock Units (8) (8) Common Stock 8,055 0.00 D
Employee Stock Option - Right to Buy (9) 03/01/2029 Common Stock 6,267 27.45 D
Restricted Stock Units (10) (10) Common Stock 6,995 0.00 D
Restricted Stock Units (11) (11) Common Stock 13,115 0.00 D
Employee Stock Option - Right to Buy (12) 03/02/2030 Common Stock 8,119 17.48 D
Restricted Stock Units (13) (13) Common Stock 15,103 0.00 D
Restricted Stock Units (14) (14) Common Stock 18,879 0.00 D
Explanation of Responses:
1. These options vested on March 6, 2016.
2. These options vested on March 5, 2017.
3. These options vested on March 4, 2018.
4. These options vested on February 17, 2019.
5. These options vested on March 3, 2020.
6. 2,626 of these options vested on March 2, 2019, 2,625 vested on March 2, 2020 and 2,625 will vest on March 2, 2021.
7. Each restricted stock unit (RSU) represents the right to receive one share of common stock of Viatris Inc. ("Viatris"). These RSUs will vest on March 2, 2021.
8. Each RSU represents the right to receive one share of common stock of Viatris Inc. These RSUs will vest in full on March 2, 2021.
9. One-third of these options vested on March 2, 2020 and one-third will vest on each of March 2, 2021 and March 2, 2022.
10. Each RSU represents the right to receive one share of common stock of Viatris. 3,497 of these RSUs will vest on March 2, 2021 and 3,498 will vest on March 2, 2022.
11. Each RSU represents the right to receive one share of common stock of Viatris. These RSUs will vest in full on March 2, 2022.
12. 2,707 of these options will vest on March 2, 2021 and 2,706 will vest on each of March 2, 2022 and March 2, 2023.
13. Each RSU represents the right to receive one share of common stock of Viatris. 5,035 of these RSUs will vest on March 2, 2021 and 5,034 will vest on each of March 2, 2022 and March 2, 2023.
14. Each RSU represents the right to receive one share of common stock of Viatris. These RSUs will vest in full on March 2, 2023.
Remarks:
Exhibit 24 - Power of Attorney
/s/ Kevin Macikowski, by power of attorney 03/04/2021
** 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 5 (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.
                                                                      Exhibit 24

                                 POWER OF ATTORNEY

    The undersigned hereby appoints each of Thomas D. Salus and Kevin D.
Macikowski, or any of them signing singly, and with full power of substitution,
the undersigned's true and lawful attorney-in-fact to:

    (1)   prepare, execute in the undersigned's name and on the undersigned's
          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 the undersigned to make electronic filings with the SEC of
          reports required by Section 16(a) of the Securities Exchange Act of
          1934, as amended (the "Exchange Act"), or any rule or regulation of
          the SEC;

    (2)   execute for and on behalf of the undersigned, in the undersigned's
          capacity as an officer and/or director of Viatris Inc. (the
          "Company"), Forms 3, 4, and 5 in accordance with Section 16(a) of the
          Exchange Act and the rules thereunder and any other forms or reports
          the undersigned may be required to file in connection with the
          undersigned's ownership, acquisition, or disposition of securities of
          the Company;

    (3)   do and perform any and all acts for and on behalf of the undersigned
          which may be necessary or desirable to complete and execute any such
          Form 3, 4, or 5 or any amendment or amendments thereto, and timely
          file such 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 by, the
          undersigned, it being understood that the documents executed by such
          attorney-in-fact on behalf of the undersigned pursuant to this Power
          of Attorney shall be in such form and shall contain such terms and
          conditions as such attorney-in-fact may approve in such attorney-in-
          fact's discretion.

    The undersigned hereby grants to each such attorney-in-fact full power and
authority to do and perform any and every act and thing whatsoever requisite,
necessary, or proper to be done in the exercise of any of the rights and powers
herein granted, as fully to all intents and purposes as the undersigned might or
could do if personally present, with full power of substitution or revocation,
hereby ratifying and confirming all that such attorney-in-fact, or such
attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be
done by virtue of this power of attorney and the rights and powers herein
granted.  The undersigned acknowledges that the foregoing attorneys-in-fact, in
serving in such capacity at the request of the undersigned, are not assuming,
nor is the Company assuming, any of the undersigned's responsibilities to comply
with Section 16 of the Exchange Act and the rules thereunder.

    This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4, and 5 with respect to the
undersigned's holdings of and transactions in securities issued by the Company,
unless earlier revoked by the undersigned in a signed writing delivered to the
foregoing attorneys-in-fact.

    IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of this 1st day of March, 2021.

                                          /s/ Brian Roman
                                   --------------------------------
                                             Signature

                                             Brian Roman
                                   --------------------------------
                                             Print Name