SEC FORM
3/A
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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| OMB APPROVAL |
| OMB Number: |
3235-0104 |
| Estimated average burden |
| hours per response: |
0.5 |
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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year)
09/15/2020
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3. Issuer Name and Ticker or Trading Symbol
ACCURAY INC
[ ARAY ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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Director |
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10% Owner |
| X |
Officer (give title below) |
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Other (specify below) |
| Senior VP Global Operations |
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5. If Amendment, Date of Original Filed
(Month/Day/Year)
09/25/2020
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6. Individual or Joint/Group Filing (Check Applicable Line)
| X |
Form filed by One Reporting Person |
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Form filed by More than One Reporting Person |
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| Table I - Non-Derivative Securities Beneficially Owned |
|---|
| 1. Title of Security (Instr.
4)
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2.
Amount of Securities Beneficially Owned (Instr.
4)
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3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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4. Nature of Indirect Beneficial Ownership (Instr.
5)
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| Common Stock |
126,475 |
D |
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Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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|---|
| 1. Title of Derivative Security (Instr.
4)
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2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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6. Nature of Indirect Beneficial Ownership (Instr.
5)
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| Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
| Non-Qualified Stock Option (right to buy) |
|
02/28/2030 |
Common Stock |
277,305 |
2.965 |
D |
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| Explanation of Responses: |
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By: Hazem Rashed For: Michael Hoge |
10/14/2020 |
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** 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. |
POWER OF ATTORNEY
Know all by these presents, that the undersigned hereby constitutes
and appoints i each of Shig Hamamatsu, Brandy Green, Hazem Rashed and Jesse
Chew of Accuray Incorporated the Company and ii any attorney employed in
the Palo Alto, CA office of Wilson Sonsini Goodrich & Rosati, Professional
Corporation, as the undersigneds true and lawful attorneyinfact to
1 prepare, execute in the undersigneds name and on the undersigneds 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 16a of the
Securities Exchange Act of 1934 or any rule or regulation of the SEC
2 to execute for and on behalf of the undersigned, in the undersigneds
capacity as an officer andor director of the Company, Forms 3, 4 and 5, and
any amendments thereto, and cause such forms to be filed with the SEC
pursuant to Section 16a of the Securities Exchange Act of 1934, as amended,
relating to the undersigneds beneficial ownership of securities in the
Company and
3 take any other action of any type whatsoever in connection with the
foregoing which, in the opinion of any of such attorneysinfact, may be of
benefit to, in the best interest of, or legally required by, the undersigned,
it being understood that the documents executed by any of such
attorneysinfact on behalf of the undersigned pursuant to this Power of
Attorney shall be in such form and shall contain such terms and conditions
as any of such attorneysinfact may approve in the discretion of any of such
attorneysinfact.
The undersigned hereby grants to each such attorneyinfact 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 attorneyinfact, or such attorneyinfacts 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 attorneysinfact, in serving in such capacity at the
request of the undersigned, are not assuming, nor is the Company assuming,
any of the undersigneds responsibilities to comply with Section 16 of the
Securities Exchange Act of 1934, as amended.
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 undersigneds holdings of, and transactions in, securities issued by
the Company, unless earlier revoked by the undersigned in a signed writing
delivered to the foregoing attorneysinfact.
IN WITNESS WHEREOF, the undersigned has caused this Power of
Attorney to be executed as of this 18th day of September, 2020.
Michael Hoge
Printed Name
s Michael Hoge
Signature
EXHIBT 24
