0001209191-21-067515.txt : 20211202
0001209191-21-067515.hdr.sgml : 20211202
20211202150636
ACCESSION NUMBER: 0001209191-21-067515
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: Arens Timothy J.
CENTRAL INDEX KEY: 0001506586
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-23837
FILM NUMBER: 211466210
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
2021-11-30
0
0000924717
SURMODICS INC
SRDX
0001506586
Arens Timothy J.
9924 WEST 74TH STREET
EDEN PRAIRIE
MN
55344
0
1
0
0
Chief Financial Officer
Common Stock
2021-11-30
4
F
0
650
43.93
D
60043
D
Common Stock
2021-11-30
4
A
0
4552
0.00
A
64595
D
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 Timothy J. Arens
2021-12-02