0001209191-16-135281.txt : 20160803
0001209191-16-135281.hdr.sgml : 20160803
20160803174040
ACCESSION NUMBER: 0001209191-16-135281
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160801
FILED AS OF DATE: 20160803
DATE AS OF CHANGE: 20160803
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: Arens Timothy J.
CENTRAL INDEX KEY: 0001506586
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-23837
FILM NUMBER: 161804989
MAIL ADDRESS:
STREET 1: 9924 WEST 74TH STREET
CITY: EDEN PRAIRIE
STATE: X1
ZIP: 55344
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2016-08-01
0
0000924717
SURMODICS INC
SRDX
0001506586
Arens Timothy J.
9924 WEST 74TH STREET
EDEN PRAIRIE
MN
55344
0
1
0
0
VP-Corporate Dev. and Strategy
Common Stock
2016-08-01
4
M
0
4000
24.30
A
13196
D
Common Stock
2016-08-01
4
F
0
3726
27.06
D
9470
D
Common Stock
2016-08-01
4
M
0
3444
9.25
A
12914
D
Common Stock
2016-08-01
4
F
0
1925
27.06
D
10989
D
Common Stock
2016-08-01
4
M
0
21469
12.40
A
32458
D
Common Stock
2016-08-01
4
F
0
13746
27.06
D
18712
D
Stock Option (right to buy)
24.30
2016-08-01
4
M
0
4000
0.00
D
2016-09-21
Common Stock
4000
0
D
Stock Option (right to buy)
9.25
2016-08-01
4
M
0
3444
0.00
D
2017-11-30
Common Stock
3444
0
D
Stock Option (right to buy)
12.40
2016-08-01
4
M
0
21469
0.00
D
2018-11-30
Common Stock
21469
0
D
The reporting person makes a payment of exercise price or tax liability by delivering or withholding securities incident to the receipt, exercise or
vesting of a security issued in accordance with Rule 16b-3.
This option is fully vested.
/s/ Bryan K. Phillips on behalf of Timothy J. Arens
2016-08-03