0001209191-15-086685.txt : 20151222 0001209191-15-086685.hdr.sgml : 20151222 20151222173246 ACCESSION NUMBER: 0001209191-15-086685 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: KALICH RONALD B SR CENTRAL INDEX KEY: 0001198349 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-23837 FILM NUMBER: 151303712 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2015-12-18 0 0000924717 SURMODICS INC SRDX 0001198349 KALICH RONALD B SR 9924 WEST 74TH STREET EDEN PRAIRIE MN 55344 1 0 0 0 Common Stock 2015-12-18 4 A 0 1486 0.00 A 5488 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 3,821 restricted stock units (RSUs) that vest on service-based vesting dates and 1,667 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 Ronald B. Kalich 2015-12-22