SEC FORM 4 SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
KOCH DAVID A

(Last) (First) (Middle)
505 N. HIGHWAY 169
SUITE 595

(Street)
PLYMOUTH MN 55441

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
SURMODICS INC [ SRDX ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
07/25/2006
4. 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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 07/25/2006 S 900 D $37.11 748,683 D
Common Stock 07/25/2006 S 800 D $37.13 747,883 D
Common Stock 07/25/2006 S 100 D $37.14 747,783 D
Common Stock 07/25/2006 S 1,500 D $37.17 746,283 D
Common Stock 07/25/2006 S 200 D $37.18 746,083 D
Common Stock 07/25/2006 S 1,300 D $37.2 744,783 D
Common Stock 07/25/2006 S 1,000 D $37.24 743,783 D
Common Stock 07/25/2006 S 800 D $37.32 742,983 D
Common Stock 07/25/2006 S 100 D $37.34 742,883 D
Common Stock 07/25/2006 S 200 D $37.36 742,683 D
Common Stock 140,000 I By Trust(1)
Common Stock 32,000 I By Spouse
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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 Securities Underlying Derivative Security (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: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Director Stock Option (Right to Buy) $6.563 (2) 05/17/2009 Common Stock 9,000 9,000 D
Director Stock Option (Right to Buy) $25.094 (3) 09/18/2010 Common Stock 2,000 2,000 D
Director Stock Option (Right to Buy) $34.85 (4) 11/21/2011 Common Stock 1,000 1,000 D
Director Stock Option (Right to Buy) $29.17 (5) 03/17/2013 Common Stock 2,000 2,000 D
Director Stock Option (Right to Buy) $21.82 (6) 05/17/2014 Common Stock 5,000 5,000 D
Director Stock Option (Right to Buy) $39.13 (7) 11/14/2015 Common Stock 5,000 5,000 D
Explanation of Responses:
1. These shares are owned by a trust established under the will of Clarissa L. Gray. The wife and children of David A. Koch are among the beneficiaries of the trust. The trustees of the trust are David A. Koch, Paul M. Torgerson and U.S. Bank Trust National Association SD.
2. Exercisable in annual increments of 1,800 shares each commencing 5/17/99.
3. Exercisable in annual increments of 400 shares each commencing 9/18/00.
4. Exercisable in annual increments of 200 shares each commencing 11/21/01.
5. Exercisable in annual increments of 400 shares each commencing 3/17/03.
6. Exercisable in annual increments of 1,000 shares each commencing 5/17/04.
7. Exercisable in annual increments of 1,000 shares each commencing 11/14/05.
Remarks:
Form two of two forms filed for Table I transactions.
/s/ David A. Koch 07/26/2006
** 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 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).
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.