0001209191-16-138661.txt : 20160825 0001209191-16-138661.hdr.sgml : 20160825 20160825165143 ACCESSION NUMBER: 0001209191-16-138661 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160823 FILED AS OF DATE: 20160825 DATE AS OF CHANGE: 20160825 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: Maharaj Gary R CENTRAL INDEX KEY: 0001508798 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-23837 FILM NUMBER: 161852077 MAIL ADDRESS: STREET 1: 9924 WEST 74TH STREET CITY: EDEN PRAIRIE STATE: MN ZIP: 55344 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2016-08-23 0 0000924717 SURMODICS INC SRDX 0001508798 Maharaj Gary R 9924 WEST 74TH STREET EDEN PRAIRIE MN 55344 1 1 0 0 President & CEO Common Stock 2016-08-23 4 M 0 68565 11.61 A 163070 D Common Stock 2016-08-23 4 F 0 42420 29.58 D 120650 D Common Stock 2016-08-23 4 M 0 62022 12.40 A 182672 D Common Stock 2016-08-23 4 F 0 43363 29.58 D 139309 D Stock Option (Right to Buy) 11.61 2016-08-23 4 M 0 68565 0.00 D 2017-12-27 Common Stock 68565 0 D Stock Option (Right to Buy) 12.40 2016-08-23 4 M 0 62022 0.00 D 2018-11-30 Common Stock 62022 0 D Includes 690 shares acquired through the Employee Stock Purchase Plan for the phase ending February 29, 2016. 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 Gary R. Maharaj 2016-08-25