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