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