-----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, R04DodjfzbCJNhfpk1ePniylwHdP5sd9FbZSxN9fqcEZsvw9jwT7wBL0dtH/qqzv IkmCVzs10w0+CX8/coTAvg== 0000914190-04-000043.txt : 20040129 0000914190-04-000043.hdr.sgml : 20040129 20040129163433 ACCESSION NUMBER: 0000914190-04-000043 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040126 FILED AS OF DATE: 20040129 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: 04552891 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 4 2004-01-26 0000924717 SURMODICS INC SRDX 0001077511 OLSETH DALE R 9924 WEST 74TH STREET EDEN PRAIRIE MN 55344 1 1 0 0 Chairman and CEO Common Stock 1289000 D Common Stock 5000 I By Spouse Common Stock 2500 I By Grandchildren's Trust Employee Stock Option (Right to Buy) 3.875 2005-09-21 Common Stock 20000 20000 D Employee Stock Option (Right to Buy) 8.0625 2006-09-20 Common Stock 30000 30000 D Employee Stock Option (Right to Buy) 25.094 2007-09-18 Common Stock 14260 14260 D Employee Stock Option (Right to Buy) 29.17 2010-03-17 Common Stock 20000 20000 D Non-Qualified Stock Option (Right to Buy) 21.36 2004-01-26 4 A 0 25000 0 A 2011-01-26 Common Stock 25000 25000 D Exercisable 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. Exercisable in annual increments of 5,000 shares each commencing 1/26/05. Dale R. Olseth 2004-01-29 -----END PRIVACY-ENHANCED MESSAGE-----