0001209191-16-112436.txt : 20160404 0001209191-16-112436.hdr.sgml : 20160404 20160404173730 ACCESSION NUMBER: 0001209191-16-112436 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160331 FILED AS OF DATE: 20160404 DATE AS OF CHANGE: 20160404 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: 161552067 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 2016-03-31 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 2016-03-31 4 A 0 642 18.41 A 12688 D The reporting person elected to receive vested deferred stock units (DSUs) in lieu of quarterly cash retainer payments. The DSUs are settled in shares of the issuer's common stock as described below. The amount beneficially owned includes 5,693 restricted stock units (RSUs) that vest on service-based vesting dates and 6,495 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. /s/ Bryan K. Phillips, on behalf of David R. Dantzker 2016-04-04