SEC Filing | Surmodics, Inc.

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SEC FORM 3 SEC Form 3

FORM 3

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940

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1. Name and Address of Reporting Person^*

Anderson Aron B

(Last)

(First)

(Middle)

9924 WEST 74TH STREET

(Street)

EDEN PRAIRIE

55344-3523

(City)

(State)

(Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
01/31/2005

3. Issuer Name and Ticker or Trading Symbol
SURMODICS INC [ SRDX ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

	Director	10% Owner
X	Officer (give title below)	Other (specify below)
VP & Chief Scientific Officer

5. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

X	Form filed by One Reporting Person
	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4)	2. Amount of Securities Beneficially Owned (Instr. 4)	3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock	29,017	D

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4)	2. Date Exercisable and Expiration Date (Month/Day/Year)		3. Title and Amount of Securities Underlying Derivative Security (Instr. 4)		4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
1. Title of Derivative Security (Instr. 4)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
Incentive Stock Option (Right to Buy)	⁽¹⁾	09/20/2006	Common Stock	2,000	8.063	D
Incentive Stock Option (Right to Buy)	⁽²⁾	09/18/2007	Common Stock	4,000	25.094	D
Incentive Stock Option (Right to Buy)	⁽³⁾	11/12/2008	Common Stock	2,500	34.85	D
Incentive Stock Option (Right to Buy)	⁽⁴⁾	01/15/2010	Common Stock	3,000	29.5	D
Incentive Stock Option (Right to Buy)	⁽⁵⁾	05/17/2011	Common Stock	3,000	21.82	D

Explanation of Responses:

1. Exercisable in annual increments of 400 shares each commencing on 9/20/00.

2. Exercisable in annual increments of 800 shares each commencing on 9/18/01.

3. Exercisable in annual increments of 500 shares each commencing on 11/12/02.

4. Exercisable in annual increments of 600 shares each commencing on 1/15/04.

5. Exercisable in annual increments of 600 shares each commencing on 5/17/05.

Remarks:

	Aron B. Anderson	02/02/2005
	** Signature of Reporting Person	Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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 Number.