0001209191-11-059251.txt : 20111202
0001209191-11-059251.hdr.sgml : 20111202
20111202180637
ACCESSION NUMBER: 0001209191-11-059251
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20111130
FILED AS OF DATE: 20111202
DATE AS OF CHANGE: 20111202
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: BRAINERD MARY K
CENTRAL INDEX KEY: 0001195918
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-23837
FILM NUMBER: 111241547
MAIL ADDRESS:
STREET 1: 8170 33RD AVENUE SOUTH
CITY: BLOOMINGTON
STATE: MN
ZIP: 55425
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: SURMODICS INC
CENTRAL INDEX KEY: 0000924717
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 411356149
STATE OF INCORPORATION: MN
FISCAL YEAR END: 0930
BUSINESS ADDRESS:
STREET 1: 9924 W 74TH ST
CITY: EDEN PRAIRIE
STATE: MN
ZIP: 55344
BUSINESS PHONE: 6128292700
MAIL ADDRESS:
STREET 1: 9924 WEST 74TH ST
CITY: EDEN PRAIRIE
STATE: MN
ZIP: 55344
FORMER COMPANY:
FORMER CONFORMED NAME: BSI CORP
DATE OF NAME CHANGE: 19970506
4
1
doc4.xml
FORM 4 SUBMISSION
X0304
4
2011-11-30
0
0000924717
SURMODICS INC
SRDX
0001195918
BRAINERD MARY K
8170 33RD AVENUE SOUTH
BLOOMINGTON
MN
55425
1
0
0
0
Stock Option (Option to Buy)
12.40
2011-11-30
4
A
0
11450
0.00
A
2018-11-30
Common Stock
11450
11450
D
Represents a stock option award granted pursuant to the issuer's Board Compensation Policy, amended and restated as of February 8, 2010.
The award vests in four equal installments on each of the first four anniversaries of the November 30, 2011 grant date.
/s/ Bryan K. Phillips, on behalf of Mary K. Brainerd
2011-12-02