0001209191-15-086455.txt : 20151221 0001209191-15-086455.hdr.sgml : 20151221 20151221182613 ACCESSION NUMBER: 0001209191-15-086455 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20151217 FILED AS OF DATE: 20151221 DATE AS OF CHANGE: 20151221 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: LaFrence Andrew D. C. CENTRAL INDEX KEY: 0001569676 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-23837 FILM NUMBER: 151300410 MAIL ADDRESS: STREET 1: 10475 110TH STREET NORTH CITY: STILLWATER STATE: MN ZIP: 55082 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2015-12-17 0 0000924717 SURMODICS INC SRDX 0001569676 LaFrence Andrew D. C. 9924 WEST 74TH STREET EDEN PRAIRIE MN 55344 0 1 0 0 VP of Finance & CFO Common Stock 2015-12-17 4 A 0 4679 0.00 A 8556 D Common Stock 2015-12-17 4 F 0 1573 20.25 D 7260 D Common Stock 20.25 2015-12-17 4 A 0 19927 0.00 A 2022-12-17 Common Stock 19927 19927 D Performance shares awarded under long-term incentive plan based on performance during three-year period ended November 30, 2014. Shares withheld to satisfy taxes incident to vesting of performance share award. Includes 277 shares acquired through the Employee Stock Purchase Plan for the phase ending 8/31/15. The award vests in four equal installments on each of the first four anniversaries of the December 17, 2015 grant date. /s/ Bryan K. Phillips, on behalf of Andrew D.C. LaFrence 2015-12-21