0001209191-12-057795.txt : 20121214
0001209191-12-057795.hdr.sgml : 20121214
20121214164300
ACCESSION NUMBER: 0001209191-12-057795
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20121212
FILED AS OF DATE: 20121214
DATE AS OF CHANGE: 20121214
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
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: DANTZKER DAVID
CENTRAL INDEX KEY: 0001245926
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-23837
FILM NUMBER: 121266098
MAIL ADDRESS:
STREET 1: 80 CUTTERMILL ROAD STE 311
CITY: GREAT NECK
STATE: NY
ZIP: 11021
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2012-12-12
0
0000924717
SURMODICS INC
SRDX
0001245926
DANTZKER DAVID
C/O WHEATLEY PARTNERS, L.P.
80 CUTTERMILL ROAD
GREAT NECK
NY
11021
1
0
0
0
Common Stock
2012-12-12
4
A
0
1472
0.00
A
1972
D
Stock Option (Right to Buy)
20.37
2012-12-12
4
A
0
3537
0.00
A
2019-12-12
Common Stock
3537
3537
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 December 12, 2012 grant date.
/s/ Bryan K. Phillips, on behalf of David R. Dantzker
2012-12-14