0001209191-21-067524.txt : 20211202
0001209191-21-067524.hdr.sgml : 20211202
20211202151028
ACCESSION NUMBER: 0001209191-21-067524
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: Sultana Nusrath
CENTRAL INDEX KEY: 0001802470
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-23837
FILM NUMBER: 211466236
MAIL ADDRESS:
STREET 1: 9924 WEST 74TH STREET
CITY: EDEN PRAIRIE
STATE: MN
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
2021-11-30
0
0000924717
SURMODICS INC
SRDX
0001802470
Sultana Nusrath
9924 WEST 74TH STREET
EDEN PRAIRIE
MN
55344
0
1
0
0
VP, Clinical Affairs
Common Stock
2021-11-30
4
F
0
431
43.93
D
6382
D
Common Stock
2021-11-30
4
A
0
910
0.00
A
7292
D
Employee Stock Option (right to buy)
43.93
2021-11-30
4
A
0
3667
0.00
A
2028-11-30
Common Stock
3667
3667
D
Includes 98 shares acquired for the phase ending August 31, 2020 through the Employee Stock Purchase Plan, 78 shares acquired for the phase ending February 26, 2021, and 71 shares acquired for the phase ending August 31, 2021.
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 Nusrath Sultana
2021-12-02