SEC FORM 4 SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
GOETTLER MICHAEL

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

(Street)
CANONSBURG PA 15317

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Viatris Inc [ VTRS ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Executive Officer
3. Date of Earliest Transaction (Month/Day/Year)
02/27/2023
4. 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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction 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 02/27/2023 M 119,975 A $0.00 257,130 D
Common Stock 02/27/2023 F 52,526(1) D $11.2 204,604 D
Common Stock 02/27/2023 M 8,753(2) A $0.00 213,357 D
Common Stock 02/27/2023 F 3,833(3) D $11.2 209,524 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction 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 (Month/Day/Year) 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: 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
Restricted Stock Units $0.00 02/27/2023 M 119,975 (4) (4) Common Stock 119,975 $0.00 0 D
Dividend Equivalent Units $0.00 02/27/2023 M 8,752.7549 (5) (5) Common Stock 8,752.7549 $0.00 0 D
Explanation of Responses:
1. Represents withholding of shares of common stock for the tax liability associated with the vesting and settlement of the restricted stock units (RSUs) granted on November 20, 2020.
2. Fractional shares have been rounded up in connection with the settlement described in footnote 5 pursuant to the terms of the RSU award agreement under the Viatris Inc. 2020 Stock Incentive Plan.
3. Represents withholding of shares of common stock for the tax liability associated with the vesting and settlement of the dividend equivalent units (DEUs) that accrued with respect to the 119,975 RSUs previously granted on November 20, 2020.
4. Each RSU represents the right to receive one share of common stock of Viatris Inc. (Viatris). These RSUs vested in full on February 27, 2023.
5. Represents DEUs that accrued with respect to the 119,975 RSUs previously granted on November 20, 2020 and vested on the same schedule as the underlying RSUs. On May 6, 2022, Viatris filed a registration statement on Form S-3 with respect to its Dividend Reinvestment and Share Purchase Plan; amount includes DEUs that subsequently accrued with respect to such RSUs in June 2022, September 2022 and December 2022 in transactions exempt from Section 16 under Rule 16a-11.
/s/ Kevin Macikowski, by power of attorney 03/01/2023
** 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).
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