SEC Contract Filing

Filing Date: 2020-06-09

Document Content:
<DOCUMENT>
<TYPE>EX-10.4
<SEQUENCE>6
<FILENAME>tm2021182d5_ex10-4.htm
<DESCRIPTION>EXHIBIT 10.4
<TEXT>
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<P STYLE="margin: 0">&nbsp;</P>

<P STYLE="text-align: right; margin: 0"><B>Exhibit 10.4</B></P>

<P STYLE="margin: 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">[Dealer address]</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left">&nbsp;</P>

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 <TD STYLE="vertical-align: top; width: 10%; font-size: 10pt"><B>To:</B></TD>
 <TD STYLE="vertical-align: bottom; width: 90%">
 <P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">Varex Imaging Corporation<BR>
1678 S. Pioneer Road</P>
 <P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">Salt Lake City, Utah 84104<BR>
 Attention:&nbsp;&nbsp; Matthew Lowell, Treasurer<BR>
 Telephone No.:&nbsp;&nbsp; (650) 460-8190</P>
 <P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">Email:&nbsp;&nbsp; matthew.lowell@vareximaging.com</P></TD></TR>
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 <TD STYLE="vertical-align: top; font-size: 10pt">&nbsp;</TD>
 <TD STYLE="vertical-align: bottom">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
 <TD STYLE="font-size: 10pt"><B>From:</B></TD>
 <TD>
 <P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">[Dealer name]</P></TD></TR>
<TR STYLE="vertical-align: top">
 <TD STYLE="font-size: 10pt">&nbsp;</TD>
 <TD>&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
 <TD STYLE="font-size: 10pt"><B>Re:</B></TD>
 <TD STYLE="font-size: 10pt">Additional Warrants</TD></TR>
<TR STYLE="vertical-align: top">
 <TD STYLE="font-size: 10pt">&nbsp;</TD>
 <TD STYLE="font-size: 10pt">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
 <TD STYLE="font-size: 10pt"><B>Date:</B></TD>
 <TD STYLE="font-size: 10pt; text-align: justify">June 5, 2020</TD></TR>
<TR STYLE="vertical-align: top">
 <TD STYLE="border-bottom: Black 1pt solid; font-size: 10pt">&nbsp;</TD>
 <TD STYLE="border-bottom: Black 1pt solid; font-size: 10pt; text-align: justify">&nbsp;</TD></TR>
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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">Dear Ladies and Gentlemen:</P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in">The purpose of this
letter agreement (this &#8220;<B>Confirmation</B>&#8221;) is to confirm the terms and conditions of the Warrants issued by Varex
Imaging Corporation (&#8220;<B>Company</B>&#8221;) to [Dealer] (&#8220;<B>Dealer</B>&#8221;) as of the Trade Date specified below
(the &#8220;<B>Transaction</B>&#8221;). This letter agreement constitutes a &#8220;Confirmation&#8221; as referred to in the Agreement
(as defined below). This Confirmation shall replace any previous agreements and serve as the final documentation for the Transaction.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in">The definitions and
provisions contained in the 2002 ISDA Equity Derivatives Definitions (the &#8220;<B>Equity Definitions</B>&#8221;), as published
by the International Swaps and Derivatives Association, Inc. (&#8220;<B>ISDA</B>&#8221;), are incorporated into this Confirmation.
In the event of any inconsistency between the Equity Definitions and this Confirmation, this Confirmation shall govern. For purposes
of the Equity Definitions, the Transaction shall be deemed a Share Option Transaction.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in">Each party is hereby
advised, and each such party acknowledges, that the other party has engaged in, or refrained from engaging in, substantial financial
transactions and has taken other material actions in reliance upon the parties&#8217; entry into the Transaction to which this
Confirmation relates on the terms and conditions set forth below.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in">&nbsp;</P>

<P STYLE="font: bold 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0in"><FONT STYLE="font-weight: normal">1.<FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</FONT>This Confirmation evidences a complete and binding agreement between Dealer and Company as to the terms of the Transaction
to which this Confirmation relates. This Confirmation shall supplement, form a part of, and be subject to an agreement in the form
of the 2002 ISDA Master Agreement (the &#8220;</FONT>Agreement<FONT STYLE="font-weight: normal">&#8221;) as if Dealer and Company
had executed an agreement in such form on the Trade Date (but without any Schedule except for the election of the laws of the State
of New York as the governing law (without reference to choice of law doctrine)). In the event of any inconsistency between provisions
of the Agreement and this Confirmation, this Confirmation will prevail for the purpose of the Transaction to which this Confirmation
relates. The parties hereby agree that no transaction other than the Transaction to which this Confirmation relates shall be governed
by the Agreement.</FONT></P>

<P STYLE="font: bold 10pt Times New Roman, Times, Serif; margin: 0pt