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