0001209191-17-001183.txt : 20170104
0001209191-17-001183.hdr.sgml : 20170104
20170104171613
ACCESSION NUMBER: 0001209191-17-001183
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20161230
FILED AS OF DATE: 20170104
DATE AS OF CHANGE: 20170104
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: McCormick Shawn
CENTRAL INDEX KEY: 0001454092
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-23837
FILM NUMBER: 17506924
MAIL ADDRESS:
STREET 1: 9600-54TH AVENUE NORTH
STREET 2: SUITE 100
CITY: PLYMOUTH
STATE: MN
ZIP: 55441
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2016-12-30
0
0000924717
SURMODICS INC
SRDX
0001454092
McCormick Shawn
9924 WEST 74TH STREET
EDEN PRAIRIE
MN
55344
1
0
0
0
Common Stock
2016-12-30
4
A
0
447
25.40
A
3412
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 1,486 restricted stock units (RSUs) that vest on service-based vesting dates and 1,926 deferred stock units (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 person's service as a director ends.
/s/ Bryan K. Phillips, on behalf of Shawn McCormick
2017-01-04