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*
Robey Brian L

(Last) (First) (Middle)
9924 WEST 74TH STREET

(Street)
EDEN PRAIRIE MN 55344

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
05/01/2006
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)
Vice President
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 2,000 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)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (Right to Buy) (1) 05/16/2012 Common Stock 12,500 39.97 D
Stock Option (Right to Buy) (2) 05/16/2012 Common Stock 7,500 39.97 D
Stock Option (Right to Buy) (3) 11/14/2012 Common Stock 3,500 39.13 D
Explanation of Responses:
1. Originally granted 12,500 shares on 05/16/2005, which are exercisable in annual increments of 2,500 shares each commencing 05/16/2006.
2. Originally granted 7,500 shares on 05/16/2005, which are exercisable in annual increments of 1,500 shares each commencing 05/16/2006.
3. Originally granted 3,500 shares on 11/14/2005, which are exercisable in annual increments of 700 shares each commencing 11/14/2006.
Remarks:
/s/ Brian L. Robey 05/08/2006
** 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.
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