0001209191-19-058302.txt : 20191127
0001209191-19-058302.hdr.sgml : 20191127
20191127152451
ACCESSION NUMBER: 0001209191-19-058302
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191125
FILED AS OF DATE: 20191127
DATE AS OF CHANGE: 20191127
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: DANTZKER DAVID
CENTRAL INDEX KEY: 0001245926
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-23837
FILM NUMBER: 191257299
MAIL ADDRESS:
STREET 1: 80 CUTTERMILL ROAD STE 311
CITY: GREAT NECK
STATE: NY
ZIP: 11021
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
2019-11-25
0
0000924717
SURMODICS INC
SRDX
0001245926
DANTZKER DAVID
C/O WHEATLEY PARTNERS, L.P.
80 CUTTERMILL ROAD
GREAT NECK
NY
11021
1
0
0
0
Common Stock
2019-11-25
4
M
0
3537
20.37
A
25489
D
Common Stock
2019-11-25
4
F
0
1716
42.00
D
23773
D
Stock Option (right to buy)
20.37
2019-11-25
4
M
0
3537
0.00
D
2019-12-12
Common Stock
3537
0
D
Shares withheld to cover the exercise cost of the stock option.
The amount beneficially owned includes 9,543 restricted stock units (RSUs) that vest on service-based vesting dates and 11,909 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.
Fully vested.
/s/ Bryan K. Phillips, on behalf of David R. Dantzker
2019-11-27