CUSIP No. |
868873-10-0 |
1 | NAMES OF REPORTING PERSONS. I.R.S. Identification Nos. of above persons (entities only) Dale R. Olseth |
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2 | CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS) |
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(a) o | |||||
(b) o | |||||
3 | SEC USE ONLY | ||||
4 | CITIZENSHIP OR PLACE OF ORGANIZATION | ||||
U.S.A. | |||||
5 | SOLE VOTING POWER | ||||
NUMBER OF | 1,325,780(1) | ||||
SHARES | 6 | SHARED VOTING POWER | |||
BENEFICIALLY | |||||
OWNED BY | 3,000(2) | ||||
EACH | 7 | SOLE DISPOSITIVE POWER | |||
REPORTING | |||||
PERSON | 1,325,780(1) | ||||
WITH | 8 | SHARED DISPOSITIVE POWER | |||
3,000(2) | |||||
9 | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON | ||||
1,328,780 | |||||
10 | CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS) | ||||
o | |||||
11 | PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9) | ||||
7.5% | |||||
12 | TYPE OF REPORTING PERSON (SEE INSTRUCTIONS) | ||||
IN |
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(a) | Name of Issuer SurModics, Inc. |
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(b) | Address of Issuers Principal Executive Offices 9924 West 74th Street, Eden Prairie, MN 55344 |
(a) | Name of Person Filing Dale R. Olseth |
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(b) | Address of Principal Business Office or, if none, Residence IDS Tower, 80 South Eighth Street, Suite 4900, Minneapolis, MN 55402 |
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(c) | Citizenship U.S.A. |
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(d) | Title of Class of Securities Common Stock |
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(e) | CUSIP Number 868873-10-0 |
Item 3. If this statement is filed pursuant to §§240.13d-1(b) or 240.13d-2(b) or (c), check whether the person filing is a: |
(a) | o | Broker or dealer registered under section 15 of the Act (15 U.S.C. 78o). | ||||
(b) | o | Bank as defined in section 3(a)(6) of the Act (15 U.S.C. 78c). | ||||
(c) | o | Insurance company as defined in section 3(a)(19) of the Act (15 U.S.C. 78c). | ||||
(d) | o | Investment company registered under section 8 of the Investment Company Act of 1940 (15 U.S.C 80a-8). | ||||
(e) | o | An investment adviser in accordance with §240.13d-1(b)(1)(ii)(E); | ||||
(f) | o | An employee benefit plan or endowment fund in accordance with §240.13d-1(b)(1)(ii)(F); | ||||
(g) | o | A parent holding company or control person in accordance with § 240.13d-1(b)(1)(ii)(G); | ||||
(h) | o | A savings associations as defined in Section 3(b) of the Federal Deposit Insurance Act (12 U.S.C. 1813); | ||||
(i) | o | A church plan that is excluded from the definition of an investment company under section 3(c)(14) of the Investment Company Act of 1940 (15 U.S.C. 80a-3); | ||||
(j) | o | Group, in accordance with §240.13d-1(b)(1)(ii)(J). |
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(a) | Amount beneficially owned: 1,328,780 | ||
(b) | Percent of class: 7.5% | ||
(c) | Number of shares as to which the person has: | ||
(i) | Sole power to vote or to direct the vote 1,325,780 | ||
(ii) | Shared power to vote or to direct the vote 3,000 | ||
(iii) | Sole power to dispose or to direct the disposition of 1,325,780 | ||
(iv) | Shared power to dispose or to direct the disposition of 3,000 | ||
Item 7. | Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company or Control Person |
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February 13, 2009
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Date | ||||
/s/ Dale R. Olseth
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Signature | ||||
Dale R. Olseth
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Name/Title |
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