0001209191-12-036149.txt : 20120702 0001209191-12-036149.hdr.sgml : 20120702 20120702161547 ACCESSION NUMBER: 0001209191-12-036149 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120628 FILED AS OF DATE: 20120702 DATE AS OF CHANGE: 20120702 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: OLSON CHARLES W CENTRAL INDEX KEY: 0001286125 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-23837 FILM NUMBER: 12940538 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: SURMODICS INC CENTRAL INDEX KEY: 0000924717 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] 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 X0306 4 2012-06-28 0 0000924717 SURMODICS INC SRDX 0001286125 OLSON CHARLES W 9924 WEST 74TH STREET EDEN PRAIRIE MN 55344 0 1 0 0 Senior VP & GM, Med Dev Common Stock 2012-06-28 4 F 0 1955 16.62 D 10636 D Common Stock 800 I By IRA Common Stock 190 I By Son Common Stock 190 I By Daughter 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. /s/ Bryan K. Phillips, on behalf of Charles W. Olson 2012-07-02