0001209191-11-059271.txt : 20111202 0001209191-11-059271.hdr.sgml : 20111202 20111202191836 ACCESSION NUMBER: 0001209191-11-059271 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: Lehman Mark A. CENTRAL INDEX KEY: 0001435723 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-23837 FILM NUMBER: 111241687 MAIL ADDRESS: STREET 1: 9924 WEST 74TH STREET CITY: EDEN PRAIRIE STATE: MN ZIP: 55344 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 0001435723 Lehman Mark A. 9924 WEST 74TH STREET EDEN PRAIRIE MN 55344 0 1 0 0 Corporate Controller Common Stock 2011-11-30 4 F 0 1635 12.00 D 5187 D Stock Option (Right to Buy) 12.40 2011-11-30 4 A 0 4770 0.00 A 2018-11-30 Common Stock 4770 4770 D The reporting person makes a payment of tax liability by withholding securities incident to the vesting of his restricted stock award issued in accordance with Rule 16b-3. Includes a total of 390 shares acquired through the Employee Stock Purchase Plan for the phases ended 5/31/11, 8/31/11 and 11/30/11. 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 Mark A. Lehman 2011-12-02