0001209191-14-073354.txt : 20141205
0001209191-14-073354.hdr.sgml : 20141205
20141205152852
ACCESSION NUMBER: 0001209191-14-073354
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20141203
FILED AS OF DATE: 20141205
DATE AS OF CHANGE: 20141205
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: 9525007000
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: 141269333
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
2014-12-03
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
2014-12-03
4
A
0
1407
0.00
A
8169
D
Employee Stock Option (right to buy)
21.31
2014-12-03
4
A
0
5576
0.00
A
2021-12-03
Common Stock
5576
5576
D
The amount beneficially owned includes 4207 restricted stock units (RSUs) that vest on service-based vesting dates and 3,462 DSUs that are vested upon issuance, each of which will be settled in shares of the issuer's common stock on a 1 for 1 basis when the reporting persons' service as a director ends.
The award will vest in full on 12/3/2015.
/s/ Bryan K. Phillips, on behalf of David R. Dantzker
2014-12-05