-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, TYJ2pUJef74mPdREz+IK3mQZToqbQABVYSQ8HLFLP+2KDJLe91dT4FKB5MQsikEP Q4sL3hY4NQR5VZQHINrVeA== 0000914190-03-000176.txt : 20031203 0000914190-03-000176.hdr.sgml : 20031203 20031203155445 ACCESSION NUMBER: 0000914190-03-000176 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031128 FILED AS OF DATE: 20031203 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: SURMODICS INC CENTRAL INDEX KEY: 0000924717 STANDARD INDUSTRIAL CLASSIFICATION: ADHESIVES & SEALANTS [2891] 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: 6128292700 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: OLSETH DALE R CENTRAL INDEX KEY: 0001077511 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-23837 FILM NUMBER: 031035388 BUSINESS ADDRESS: STREET 1: 9924 WEST 74TH STREET CITY: EDEN PRAIRIE STATE: MN ZIP: 55344 BUSINESS PHONE: 6128292700 MAIL ADDRESS: STREET 1: 9924 WEST 74TH STREET CITY: EDEN PRAIRIE STATE: MN ZIP: 55344 4 1 edgar.xml PRIMARY DOCUMENT X0201 42003-11-28 0000924717 SURMODICS INC SRDX 0001077511 OLSETH DALE R 9924 WEST 74TH STREET EDEN PRAIRIE MN 55344 1100Chairman and CEOCommon Stock1289000DCommon Stock5000IBy Spouse< nonDerivativeTransaction>Common Stock2003-11-284P0110021.25A0IBy Grandchildren's TrustCommon Stock2003-11-284P060021.30A0IBy Grandchildren's TrustCommon Stock2003-11-284P030021.24A0IBy Grandchildren's TrustCommon Stock2003-11-284P0200< /transactionShares>21.15A0IBy Grandchildren's TrustCommon Stock2003-11-284P020021.26A0IBy Grandchildren's TrustCommon Stock2003-11-284P010021.21A2500IBy Grandchildren's TrustEmployee Stock Option (Right to Buy)3.8752005-09-21Common Stock2000020000DEmployee Stock Option (Right to Buy)8.06252006-09-20Common Stock300003000DEmployee Stock Option (Right to Buy)25. 0942007-09-18Common Stock1426014260DEmployee Stock Option (Right to Buy)29.172010-03-17Common Stock2000020000DExercisable in annual increments of 4,000 shares each commencing 9/21/99.Exercisable in annual increments of 6,000 shares each commencing 9/20/00.Exercisable in annual increments of 2,852 shares each commencing 9/18/01.Exercisable in annual increments of 4,000 shares each commencing 3/17/04.Dale R. Olseth2003-12-03 -----END PRIVACY-ENHANCED MESSAGE-----