0001209191-21-063306.txt : 20211108 0001209191-21-063306.hdr.sgml : 20211108 20211108095536 ACCESSION NUMBER: 0001209191-21-063306 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211103 FILED AS OF DATE: 20211108 DATE AS OF CHANGE: 20211108 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: 211386829 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 2021-11-03 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 2021-11-03 4 M 0 5576 21.31 A 36397 D Common Stock 2021-11-03 4 F 0 2101 56.56 D 34296 D Stock Option (right to buy) 21.31 2021-11-03 4 M 0 5576 0.00 D 2021-12-03 Common Stock 5576 0 D The amount beneficially owned includes 10,610 restricted stock units (RSUs) that vest on service-based vesting dates and 15,026 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/ John Manders, on behalf of David R. Dantzker 2021-11-08