0001209191-21-067519.txt : 20211202 0001209191-21-067519.hdr.sgml : 20211202 20211202150854 ACCESSION NUMBER: 0001209191-21-067519 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211130 FILED AS OF DATE: 20211202 DATE AS OF CHANGE: 20211202 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: OLSON CHARLES W CENTRAL INDEX KEY: 0001286125 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-23837 FILM NUMBER: 211466223 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 2021-11-30 0 0000924717 SURMODICS INC SRDX 0001286125 OLSON CHARLES W 9924 WEST 74TH STREET EDEN PRAIRIE MN 55344 0 1 0 0 Senior VP of Bus Dev, Med Dev Common Stock 2021-11-30 4 F 0 650 43.93 D 37822 D Common Stock 2021-11-30 4 A 0 4552 0.00 A 42374 D Common Stock 800 I By IRA Employee Stock Option (right to buy) 43.93 2021-11-30 4 A 0 18337 0.00 A 2028-11-30 Common Stock 18337 18337 D The award vests in four equal installments on each of the first four anniversaries of the November 30, 2021 grant date. /s/ John Manders on behalf of Charles W. Olson 2021-12-02