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