0001209191-16-136582.txt : 20160811
0001209191-16-136582.hdr.sgml : 20160811
20160811163822
ACCESSION NUMBER: 0001209191-16-136582
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160809
FILED AS OF DATE: 20160811
DATE AS OF CHANGE: 20160811
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: OLSON CHARLES W
CENTRAL INDEX KEY: 0001286125
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-23837
FILM NUMBER: 161825153
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2016-08-09
0
0000924717
SURMODICS INC
SRDX
0001286125
OLSON CHARLES W
9924 WEST 74TH STREET
EDEN PRAIRIE
MN
55344
0
1
0
0
Senior VP & GM, Med Dev
Common Stock
2016-08-09
4
M
0
5783
24.30
A
28814
D
Common Stock
2016-08-09
4
F
0
5173
28.89
D
23641
D
Common Stock
800
I
By IRA
Stock Option (right to buy)
24.30
2016-08-09
4
M
0
5783
0.00
D
2016-09-21
Common Stock
5783
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 Charles W. Olson
2016-08-11