0001209191-12-057802.txt : 20121214 0001209191-12-057802.hdr.sgml : 20121214 20121214165622 ACCESSION NUMBER: 0001209191-12-057802 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20121212 FILED AS OF DATE: 20121214 DATE AS OF CHANGE: 20121214 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Maharaj Gary R CENTRAL INDEX KEY: 0001508798 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-23837 FILM NUMBER: 121266272 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: 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 2012-12-12 0 0000924717 SURMODICS INC SRDX 0001508798 Maharaj Gary R 9924 WEST 74TH STREET EDEN PRAIRIE MN 55344 1 1 0 0 President & CEO Stock Option (Right to Buy) 20.37 2012-12-12 4 A 0 38325 0.00 A 2019-12-12 Common Stock 38325 38325 D Represents an annual stock option award granted pursuant to the issuer's executive compensation program. 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 Gary R. Maharaj 2012-12-14