0001209191-11-059260.txt : 20111202 0001209191-11-059260.hdr.sgml : 20111202 20111202181353 ACCESSION NUMBER: 0001209191-11-059260 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: Smith Jeffrey C CENTRAL INDEX KEY: 0001362697 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-23837 FILM NUMBER: 111241577 MAIL ADDRESS: STREET 1: C/O S1 CORPORATION STREET 2: 705 WESTECH DRIVE CITY: NORCROSS STATE: GA ZIP: 30092 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 0001362697 Smith Jeffrey C C/O RAMIUS LLC LEXINGTON AVENUE, 20TH FLOOR NEW YORK NY 10022 1 0 0 0 Stock Option (Right to Buy) 12.40 2011-11-30 4 A 0 10496 0.00 A 2018-11-30 Common Stock 10496 10496 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 Jeffrey C. Smith 2011-12-02