0001209191-16-144356.txt : 20161004
0001209191-16-144356.hdr.sgml : 20161004
20161004164837
ACCESSION NUMBER: 0001209191-16-144356
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160930
FILED AS OF DATE: 20161004
DATE AS OF CHANGE: 20161004
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: KALICH RONALD B SR
CENTRAL INDEX KEY: 0001198349
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-23837
FILM NUMBER: 161919677
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2016-09-30
0
0000924717
SURMODICS INC
SRDX
0001198349
KALICH RONALD B SR
9924 WEST 74TH STREET
EDEN PRAIRIE
MN
55344
1
0
0
0
Common Stock
2016-09-30
4
A
0
465
30.09
A
7999
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 3,821 restricted stock units (RSUs) that vest on service-based vesting dates and 4,178 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 Ronald B. Kalich
2016-10-04