0001209191-15-086677.txt : 20151222 0001209191-15-086677.hdr.sgml : 20151222 20151222172947 ACCESSION NUMBER: 0001209191-15-086677 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20151218 FILED AS OF DATE: 20151222 DATE AS OF CHANGE: 20151222 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: BENSON JOHN W CENTRAL INDEX KEY: 0001196470 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-23837 FILM NUMBER: 151303621 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2015-12-18 0 0000924717 SURMODICS INC SRDX 0001196470 BENSON JOHN W 3320 PETE MILLER LANE N. STILLWATER MN 55082 1 0 0 0 Common Stock 2015-12-18 4 A 0 1486 0.00 A 14199 D Stock Option (right to buy) 20.18 2015-12-18 4 A 0 4366 0.00 A 2022-12-18 Common Stock 4366 4366 D The amount beneficially owned includes 5,693 restricted stock units (RSUs) that vest on service-based vesting dates and 4,238 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 12/18/2016. /s/ Bryan K. Phillips, on behalf of John W. Benson 2015-12-22