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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Stock Option (Right to Buy) | $ 9.25 | 12/03/2013 | D | 23,243 | (4) | 11/30/2017 | Common Stock | 23,243 | $ 0 | 7,748 | D | ||||
Stock Option (Right to Buy) | $ 12.4 | 12/03/2013 | D | 10,735 | (5) | 11/30/2018 | Common Stock | 10,735 | $ 0 | 10,734 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Phillips Bryan K 9924 WEST 74TH STREET EDEN PRAIRIE, MN 55344 |
SVP, Gen Counsel & Secretary |
/s/ Bryan K. Phillips | 12/05/2013 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | The reporting person makes a payment of exercise price or tax liability by delivering or withholding securities incident to the receipt, exercise or vesting of a security issued in accordance with Rule 16b-3. |
(2) | The sales reported in this Form 4 were effected pursuant to a Rule 10b-5 trading plan adopted by the reporting person. |
(3) | Reflects the weighted average price of 16,236 shares of common stock of SurModics, Inc. sold by the reporting person in multiple transactions on December 4, 2013 with the sale prices ranging from $22.59 to $23.415 per share. The reporting person undertakes to provide upon request by the U. S. Securities and Exchange Commission staff, the issuer, or a security holder of the issuer, full information regarding the number of shares sold at each separate price. |
(4) | The award vests in four equal installments on each of the first four anniversaries of the November 30, 2010 grant date. |
(5) | The award vests in four equal installments on each of the first four anniversaries of the November 30, 2011 grant date. |