0001209191-18-041999.txt : 20180709
0001209191-18-041999.hdr.sgml : 20180709
20180709163119
ACCESSION NUMBER: 0001209191-18-041999
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180705
FILED AS OF DATE: 20180709
DATE AS OF CHANGE: 20180709
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Arens Timothy J.
CENTRAL INDEX KEY: 0001506586
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-23837
FILM NUMBER: 18945025
MAIL ADDRESS:
STREET 1: 9924 WEST 74TH STREET
CITY: EDEN PRAIRIE
STATE: X1
ZIP: 55344
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
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2018-07-05
0
0000924717
SURMODICS INC
SRDX
0001506586
Arens Timothy J.
9924 WEST 74TH STREET
EDEN PRAIRIE
MN
55344
0
1
0
0
Interim VP, Finance, and CFO
Common Stock
2018-07-05
4
M
0
5863
21.03
A
38293
D
Common Stock
2018-07-05
4
M
0
6099
20.25
A
44392
D
Common Stock
2018-07-05
4
M
0
3964
23.95
A
48356
D
Common Stock
2018-07-05
4
F
0
8947
58.25
D
39409
D
Employee Stock Option (right to buy)
21.03
2018-07-05
4
M
0
5863
0.00
D
2021-12-02
Common Stock
5863
8413
D
Employee Stock Option (right to buy)
20.25
2018-07-05
4
M
0
6099
0.00
D
2022-12-17
Common Stock
6099
13828
D
Employee Stock Option
23.95
2018-07-05
4
M
0
3964
0.00
D
2023-11-30
Common Stock
3964
13157
D
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.
The award vests in four equal installments on each of the first four anniversaries of the December 2, 2014 grant date.
The award vests in four equal installments on each of the first four anniversaries of the December 17, 2015 grant date.
The award vests in four equal installments on each of the first four anniversaries of the November 30, 2016 grant date.
/s/ Bryan K. Phillips on behalf of Timothy J. Arens
2018-07-09