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<SEC-DOCUMENT>0000950123-11-012635.txt : 20110211
<SEC-HEADER>0000950123-11-012635.hdr.sgml : 20110211
<ACCEPTANCE-DATETIME>20110211140147
ACCESSION NUMBER:		0000950123-11-012635
CONFORMED SUBMISSION TYPE:	SC 13G/A
PUBLIC DOCUMENT COUNT:		1
FILED AS OF DATE:		20110211
DATE AS OF CHANGE:		20110211

FILED BY:		

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			OLSETH DALE R
		CENTRAL INDEX KEY:			0001077511

	FILING VALUES:
		FORM TYPE:		SC 13G/A

	MAIL ADDRESS:	
		STREET 1:		9924 WEST 74TH STREET
		CITY:			EDEN PRAIRIE
		STATE:			MN
		ZIP:			55344

SUBJECT COMPANY:	

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			SURMODICS INC
		CENTRAL INDEX KEY:			0000924717
		STANDARD INDUSTRIAL CLASSIFICATION:	PHARMACEUTICAL PREPARATIONS [2834]
		IRS NUMBER:				411356149
		STATE OF INCORPORATION:			MN
		FISCAL YEAR END:			0930

	FILING VALUES:
		FORM TYPE:		SC 13G/A
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	005-55203
		FILM NUMBER:		11597523

	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
</SEC-HEADER>
<DOCUMENT>
<TYPE>SC 13G/A
<SEQUENCE>1
<FILENAME>c62956sc13gza.htm
<DESCRIPTION>SC 13G/A
<TEXT>
<HTML>
<HEAD>
<TITLE>sc13gza</TITLE>
</HEAD>
<BODY bgcolor="#FFFFFF">
<!-- PAGEBREAK -->
<H5 align="left" style="page-break-before:always"><A HREF="#C62956toc">Table of Contents</A></H5><P>
<DIV style="font-family: 'Times New Roman',Times,serif">


<DIV style="width: 100%; border-bottom: 2pt solid black; font-size: 1pt">&nbsp;</DIV>
<DIV style="width: 100%; border-bottom: 1pt solid black; font-size: 1pt">&nbsp;</DIV>








<DIV align="center" style="font-size: 14pt; margin-top: 12pt"><B>UNITED STATES<BR>
SECURITIES AND EXCHANGE COMMISSION</B>
</DIV>

<DIV align="center" style="font-size: 12pt"><B>Washington, D.C. 20549</B>
</DIV>


<DIV align="center" style="font-size: 12pt; margin-top: 12pt"><B>SCHEDULE 13G</B>
</DIV>

<DIV align="center" style="font-size: 12pt; margin-top: 12pt"><B>Under
the Securities Exchange Act of 1934</B></div>
<DIV align="center" style="font-size: 10pt; margin-top: 0pt"><B>(Amendment No.&nbsp;10)</B></DIV>

<DIV align="center" style="font-size: 24pt; margin-top: 12pt"><B>SurModics, Inc.</B>
</DIV>

<DIV align="center" style="font-size: 10pt"><DIV style="width: 100%; border-bottom: 1px solid #000000; FONT-size: 1px">&nbsp;</DIV></DIV>


<DIV align="center" style="font-size: 10pt">(Name of Issuer)</DIV>



<DIV align="Center" style="font-size: 10pt; margin-top: 6pt"><B>Common Stock, $.05 par value</B>
</DIV>
<DIV align="center" style="font-size: 10pt"><DIV style="width: 100%; border-bottom: 1px solid #000000; FONT-size: 1px">&nbsp;</DIV></DIV>


<DIV align="center" style="font-size: 10pt">(Title of Class of Securities)</DIV>



<DIV align="Center" style="font-size: 10pt; margin-top: 6pt"><B>868873-10-0</B>
</DIV>
<DIV align="center" style="font-size: 10pt"><DIV style="width: 100%; border-bottom: 1px solid #000000; FONT-size: 1px">&nbsp;</DIV></DIV>


<DIV align="center" style="font-size: 10pt">(CUSIP Number)</DIV>



<DIV align="Center" style="font-size: 10pt; margin-top: 6pt"><B>December&nbsp;31, 2010</B>
</DIV>
<DIV align="center" style="font-size: 10pt"><DIV style="width: 100%; border-bottom: 1px solid #000000; FONT-size: 1px">&nbsp;</DIV></DIV>


<DIV align="center" style="font-size: 10pt">(Date of Event Which Requires Filing of this Statement)</DIV>


<DIV align="left" style="font-size: 10pt; margin-top: 6pt">Check the appropriate box to designate the rule pursuant to which this Schedule is filed:
</DIV>


<DIV style="margin-top: 6pt">
<TABLE width="100%" border="0" cellpadding="0" cellspacing="0" style="font-size: 10pt">

<TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">

    <TD width="2%" nowrap align="left">&nbsp;</TD>
    <TD width="1%">&nbsp;</TD>
    <TD><FONT style="font-family: Wingdings">&#111;</FONT> Rule&nbsp;13d-1(b)</TD>
</TR>

<TR>
    <TD style="font-size: 6pt">&nbsp;</TD>
</TR><TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">

    <TD width="2%" nowrap align="left">&nbsp;</TD>
    <TD width="1%">&nbsp;</TD>
    <TD><FONT style="font-family: Wingdings">&#254;</FONT> Rule&nbsp;13d-1(c)</TD>
</TR>

<TR>
    <TD style="font-size: 6pt">&nbsp;</TD>
</TR><TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">

    <TD width="2%" nowrap align="left">&nbsp;</TD>
    <TD width="1%">&nbsp;</TD>
    <TD><FONT style="font-family: Wingdings">&#111;</FONT> Rule&nbsp;13d-1(d)</TD>
</TR>

</TABLE>
</DIV>

<DIV style="margin-top: 6pt">
<TABLE width="100%" border="0" cellpadding="0" cellspacing="0" style="font-size: 10pt">

<TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">

    <TD width="2%" nowrap align="left">*</TD>
    <TD width="1%">&nbsp;</TD>
    <TD>The remainder of this cover page shall be filled out for a reporting person&#146;s initial
filing on this form with respect to the subject class of securities, and for any
subsequent amendment containing information which would alter the disclosures provided
in a prior cover page.</TD>
</TR>

<TR>
    <TD style="font-size: 6pt">&nbsp;</TD>
</TR><TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">

    <TD width="2%" nowrap align="left">&nbsp;</TD>
    <TD width="1%">&nbsp;</TD>
    <TD>The information required in the remainder of this cover page shall not be deemed to be
&#147;filed&#148; for the purpose of Section&nbsp;18 of the Securities Exchange Act of 1934 (&#147;Act&#148;) or
otherwise subject to the liabilities of that section of the Act but shall be subject to
all other provisions of the Act (however, <I>see </I>the <I>Notes</I>).</TD>
</TR>

</TABLE>
</DIV>

<DIV style="width: 100%; border-bottom: 1pt solid black; margin-top: 10pt; font-size: 1pt">&nbsp;</DIV>
<DIV style="width: 100%; border-bottom: 2pt solid black; font-size: 1pt">&nbsp;</DIV>










<P align="center" style="font-size: 10pt"><!-- Folio --><!-- /Folio -->
</DIV>




<!-- PAGEBREAK -->
<P><HR noshade><P>



<DIV style="font-family: 'Times New Roman',Times,serif">

<!-- TOC -->
<A name="C62956toc"><DIV align="CENTER" style="page-break-before:always"><U><B>TABLE OF CONTENTS</B></U></DIV></A>

<P><CENTER>
<TABLE border="0" width="90%" cellpadding="0" cellspacing="0">
<TR>
	<TD width="3%"></TD>
	<TD width="3%"></TD>
	<TD width="3%"></TD>
	<TD width="3%"></TD>
	<TD width="3%"></TD>
	<TD width="3%"></TD>
	<TD width="3%"></TD>
	<TD width="3%"></TD>
	<TD width="76%"></TD>
</TR>
<TR><TD></TD><TD colspan="8"><A HREF="#C62956000">Item&nbsp;1</A></TD></TR>
<TR><TD></TD><TD colspan="8"><A HREF="#C62956001">Item&nbsp;2</A></TD></TR>
<TR><TD></TD><TD colspan="8"><A HREF="#C62956002">Item&nbsp;3. If this statement is filed pursuant to &#167;&#167;240.13d-1(b) or 240.13d-2(b) or (c), check whether the person filing is a:</A></TD></TR>
<TR><TD></TD><TD colspan="8"><A HREF="#C62956003">Item&nbsp;4. Ownership</A></TD></TR>
<TR><TD></TD><TD colspan="8"><A HREF="#C62956004">Item&nbsp;5. Ownership of Five Percent or Less of a Class</A></TD></TR>
<TR><TD></TD><TD colspan="8"><A HREF="#C62956005">Item&nbsp;6. Ownership of More than Five Percent on Behalf of Another Person</A></TD></TR>
<TR><TD></TD><TD colspan="8"><A HREF="#C62956006">Item&nbsp;7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company or Control Person</A></TD></TR>
<TR><TD></TD><TD colspan="8"><A HREF="#C62956007">Item&nbsp;8. Identification and Classification of Members of the Group</A></TD></TR>
<TR><TD></TD><TD colspan="8"><A HREF="#C62956008">Item&nbsp;9. Notice of Dissolution of Group</A></TD></TR>
<TR><TD></TD><TD colspan="8"><A HREF="#C62956009">Item&nbsp;10. Certification</A></TD></TR>
<TR><TD colspan="9"><A HREF="#C62956010">Signature</A></TD></TR>
</TABLE>
</CENTER>
<!-- /TOC -->
<P><HR noshade><P>
<H5 align="left" style="page-break-before:always"><A HREF="#C62956toc">Table of Contents</A></H5><P>

<DIV align="center">
<TABLE style="font-size: 10pt" cellspacing="0" border="0" cellpadding="0" width="100%">
<!-- Begin Table Head -->
<TR valign="bottom">
<TD width="1%">&nbsp;</TD>
<TD width="1%">&nbsp;</TD>
<TD width="20%">&nbsp;</TD>
<TD width="55%">&nbsp;</TD>
<TD width="1%">&nbsp;</TD>
<TD width="1%">&nbsp;</TD>
<TD width="9%">&nbsp;</TD>
<TD width="1%">&nbsp;</TD>
<TD width="1%">&nbsp;</TD>
<TD width="1%">&nbsp;</TD>
<TD width="9%">&nbsp;</TD>
</TR>
<!-- End Table Head -->
<!-- Begin Table Body -->






<TR valign="bottom">
<TD valign="top" nowrap><DIV style="margin-left:0px; text-indent:-0px">CUSIP No.</DIV></TD>
<TD>&nbsp;</TD>
<TD align="center" valign="top"><DIV style="border: 1px solid #000000"> 868873-10-0&nbsp;</DIV></TD>
<TD>&nbsp;</TD>
</TR>
<!-- End Table Body -->
</TABLE>
</DIV>


<P>&nbsp;<DIV style="width: 100%; border: 1px solid black"><DIV align="center">

<TABLE style="font-size: 10pt" cellspacing="0" border="0" cellpadding="1" width="100%">
<!-- Begin Table Head --><TR style="font-size: 1px">
<TD width="5%">&nbsp;</TD>
<TD width="1%" style="border-left: 1px solid #000000">&nbsp;</TD>
<TD width="5%">&nbsp;</TD>
<TD width="5%">&nbsp;</TD>
<TD width="1%">&nbsp;</TD>
<TD width="83%">&nbsp;</TD>
</TR>

<!-- End Table Head -->
<!-- Begin Table Body -->
<TR valign="bottom">
<TD valign="middle" align="center"><FONT style="font-size: 18pt"><B>1</B></FONT></TD>
<TD style="border-left: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left">NAMES OF REPORTING PERSONS <BR>
<BR>
I.R.S. Identification Nos. of above persons (entities only)<BR>

<BR>
<B>Dale R. Olseth</B></TD>
</TR>
<TR valign="bottom">
<TD>&nbsp;</TD>
<TD style="border-left: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left">&nbsp;</TD>
</TR>

<TR style="font-size: 1px">
<TD style="border-top: 1px solid #000000">&nbsp;</TD>
<TD style="border-left: 1px solid #000000; border-top: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left" style="border-top: 1px solid #000000">&nbsp;</TD>
</TR>


<TR valign="bottom">
<TD valign="middle" align="center" rowspan="3"><FONT style="font-size: 18pt"><B>2</B></FONT></TD>
<TD style="border-left: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left">CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS)<BR><BR></TD>
</TR>

<TR valign="bottom">
<TD style="border-left: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left">(a)&nbsp;&nbsp;&nbsp;<FONT face="wingdings" size="2">&#111;</FONT></TD>
</TR>

<TR valign="bottom">
<TD style="border-left: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left">(b)&nbsp;&nbsp;&nbsp;<FONT face="wingdings" size="2">&#111;</FONT></TD>
</TR>

<TR style="font-size: 1px">
<TD style="border-top: 1px solid #000000">&nbsp;</TD>
<TD style="border-left: 1px solid #000000; border-top: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left" style="border-top: 1px solid #000000">&nbsp;</TD>
</TR>

<TR valign="bottom">
<TD valign="middle" align="center" rowspan="3"><FONT style="font-size: 18pt"><B>3</B></FONT></TD>
<TD style="border-left: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left">SEC USE ONLY</TD>
</TR>
<TR valign="bottom">
<TD style="border-left: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left">&nbsp;</TD>
</TR>
<TR valign="bottom">
<TD style="border-left: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left">&nbsp;</TD>
</TR>

<TR style="font-size: 1px">
<TD style="border-top: 1px solid #000000">&nbsp;</TD>
<TD style="border-left: 1px solid #000000; border-top: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left" style="border-top: 1px solid #000000">&nbsp;</TD>
</TR>

<TR valign="bottom">
<TD valign="middle" align="center" rowspan="3"><FONT style="font-size: 18pt"><B>4</B></FONT></TD>
<TD style="border-left: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left">CITIZENSHIP OR PLACE OF ORGANIZATION</TD>
</TR>
<TR valign="bottom">
<TD style="border-left: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left">&nbsp;</TD>
</TR>
<TR valign="bottom">
<TD style="border-left: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left"><B>U.S.A</B></TD>
</TR>

<TR style="font-size: 1px">
<TD colspan="3" align="left" style="border-top: 1px solid #000000">&nbsp;</TD>
<TD align="left" style="border-top: 1px solid #000000; border-left: 1px solid #000000; border-right: 1px solid #000000">&nbsp;</TD>
<TD align="left" style="border-top: 1px solid #000000">&nbsp;</TD>
<TD align="left" style="border-top: 1px solid #000000">&nbsp;</TD>
</TR>

<TR valign="bottom">
<TD align="center" colspan="3">&nbsp;</TD>
<TD valign="middle" align="center" rowspan="3" style="border-left: 1px solid #000000; border-right: 1px solid #000000"><FONT style="font-size: 18pt"><B>5</B></FONT></TD>
<TD>&nbsp;</TD>
<TD align="left">SOLE VOTING POWER</TD>
</TR>
<TR valign="bottom">
<TD align="center" colspan="3">&nbsp;</TD>
<TD>&nbsp;</TD>
<TD>&nbsp;</TD>
</TR>
<TR valign="bottom">
<TD align="center" colspan="3">NUMBER OF</TD>
<TD>&nbsp;</TD>
<TD align="left"><B>760,619</B>(1)</TD>
</TR>

<TR style="font-size: 1px">
<TD colspan="3">&nbsp;</TD>
<TD align="left" style="border-top: 1px solid #000000; border-left: 1px solid #000000; border-right: 1px solid #000000">&nbsp;</TD>
<TD align="left" style="border-top: 1px solid #000000">&nbsp;</TD>
<TD align="left" style="border-top: 1px solid #000000">&nbsp;</TD>
</TR>

<TR valign="bottom">
<TD align="center" colspan="3">SHARES</TD>
<TD valign="middle" align="center" rowspan="3" style="border-left: 1px solid #000000; border-right: 1px solid #000000"><FONT style="font-size: 18pt"><B>6</B></FONT></TD>
<TD>&nbsp;</TD>
<TD align="left">SHARED VOTING POWER</TD>
</TR>
<TR valign="bottom">
<TD align="center" colspan="3">BENEFICIALLY</TD>
<TD>&nbsp;</TD>
<TD>&nbsp;</TD>
</TR>
<TR valign="bottom">
<TD align="center" colspan="3">OWNED BY</TD>
<TD>&nbsp;</TD>
<TD><B>0</B></TD>
</TR>

<TR style="font-size: 1px">
<TD colspan="3">&nbsp;</TD>
<TD align="left" style="border-top: 1px solid #000000; border-left: 1px solid #000000; border-right: 1px solid #000000">&nbsp;</TD>
<TD align="left" style="border-top: 1px solid #000000">&nbsp;</TD>
<TD align="left" style="border-top: 1px solid #000000">&nbsp;</TD>
</TR>

<TR valign="bottom">
<TD align="center" colspan="3">EACH</TD>
<TD valign="middle" align="center" rowspan="3" style="border-left: 1px solid #000000; border-right: 1px solid #000000"><FONT style="font-size: 18pt"><B>7</B></FONT></TD>
<TD>&nbsp;</TD>
<TD align="left">SOLE DISPOSITIVE POWER</TD>
</TR>
<TR valign="bottom">
<TD align="center" colspan="3">REPORTING</TD>
<TD>&nbsp;</TD>
<TD>&nbsp;</TD>
</TR>
<TR valign="bottom">
<TD align="center" colspan="3">PERSON</TD>
<TD>&nbsp;</TD>
<TD align="left"><B>760,619</B>(1)</TD>
</TR>

<TR style="font-size: 1px">
<TD colspan="3">&nbsp;</TD>
<TD align="left" style="border-top: 1px solid #000000; border-left: 1px solid #000000; border-right: 1px solid #000000">&nbsp;</TD>
<TD align="left" style="border-top: 1px solid #000000">&nbsp;</TD>
<TD align="left" style="border-top: 1px solid #000000">&nbsp;</TD>
</TR>

<TR valign="bottom">
<TD align="center" colspan="3">WITH</TD>
<TD valign="middle" align="center" rowspan="3" style="border-left: 1px solid #000000; border-right: 1px solid #000000"><FONT style="font-size: 18pt"><B>8</B></FONT></TD>
<TD>&nbsp;</TD>
<TD align="left">SHARED DISPOSITIVE POWER</TD>
</TR>
<TR valign="bottom">
<TD align="center" colspan="3">&nbsp;</TD>
<TD>&nbsp;</TD>
<TD>&nbsp;</TD>
</TR>
<TR valign="bottom">
<TD align="center" colspan="3">&nbsp;</TD>
<TD>&nbsp;</TD>
<TD align="left"><B>0</B></TD>
</TR>

<TR style="font-size: 1px">
<TD style="border-top: 1px solid #000000">&nbsp;</TD>
<TD style="border-left: 1px solid #000000; border-top: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left" style="border-top: 1px solid #000000">&nbsp;</TD>
</TR>

<TR valign="bottom">
<TD valign="middle" align="center" rowspan="3"><FONT style="font-size: 18pt"><B>9</B></FONT></TD>
<TD style="border-left: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left">AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON</TD>
</TR>
<TR valign="bottom">
<TD style="border-left: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left">&nbsp;</TD>
</TR>
<TR valign="bottom">
<TD style="border-left: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left"><B>760,619</B></TD>
</TR>

<TR style="font-size: 1px">
<TD style="border-top: 1px solid #000000">&nbsp;</TD>
<TD style="border-left: 1px solid #000000; border-top: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left" style="border-top: 1px solid #000000">&nbsp;</TD>
</TR>

<TR valign="bottom">
<TD valign="middle" align="center" rowspan="3"><FONT style="font-size: 18pt"><B>10</B></FONT></TD>
<TD style="border-left: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left">CHECK IF THE AGGREGATE AMOUNT IN ROW (9)&nbsp;EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)</TD>
</TR>
<TR valign="bottom">
<TD style="border-left: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left">&nbsp;</TD>
</TR>
<TR valign="bottom">
<TD style="border-left: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left"><FONT face="wingdings" size="2">&#111;</FONT></TD>
</TR>

<TR style="font-size: 1px">
<TD style="border-top: 1px solid #000000">&nbsp;</TD>
<TD style="border-left: 1px solid #000000; border-top: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left" style="border-top: 1px solid #000000">&nbsp;</TD>
</TR>

<TR valign="bottom">
<TD valign="middle" align="center" rowspan="3"><FONT style="font-size: 18pt"><B>11</B></FONT></TD>
<TD style="border-left: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left">PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)</TD>
</TR>
<TR valign="bottom">
<TD style="border-left: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left">&nbsp;</TD>
</TR>
<TR valign="bottom">
<TD style="border-left: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left"><B>4.3&#37;</B></TD>
</TR>

<TR style="font-size: 1px">
<TD style="border-top: 1px solid #000000">&nbsp;</TD>
<TD style="border-left: 1px solid #000000; border-top: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left" style="border-top: 1px solid #000000">&nbsp;</TD>
</TR>

<TR valign="bottom">
<TD valign="middle" align="center" rowspan="3"><FONT style="font-size: 18pt"><B>12</B></FONT></TD>
<TD style="border-left: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left">TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)</TD>
</TR>
<TR valign="bottom">
<TD style="border-left: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left">&nbsp;</TD>
</TR>
<TR valign="bottom">
<TD style="border-left: 1px solid #000000">&nbsp;</TD>
<TD colspan="4" align="left"><B>IN</B></TD>
</TR>
<!-- End Table Body --></TABLE>
</DIV>
</DIV>

<DIV style="font-size: 10pt; margin-top: 3pt">(1) Includes vested options to purchase 9,000 shares of common stock.
</DIV>

<DIV style="font-size: 10pt; margin-top: 3pt">
</DIV>

<DIV style="font-size: 10pt; margin-top: 3pt">
</DIV>

<DIV style="font-size: 10pt; margin-top: 3pt">
</DIV>


<P align="center" style="font-size: 10pt"> 2


</DIV>

<!-- PAGEBREAK -->
<P><HR noshade><P>
<H5 align="left" style="page-break-before:always"><A HREF="#C62956toc">Table of Contents</A></H5><P>
<DIV style="font-family: 'Times New Roman',Times,serif">

<!-- link2 "Item&nbsp;1" -->
<DIV align="left"><A NAME="C62956000"></A></DIV>

<DIV style="margin-top: 6pt">
<TABLE width="100%" border="0" cellpadding="0" cellspacing="0" style="font-size: 10pt">

<TR>
    <TD style="font-size: 6pt">&nbsp;</TD>
</TR><TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="2%" nowrap align="left"><B>Item&nbsp;1.</B></TD>
    <TD width="1%">&nbsp;</TD>
    <TD>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</TD>
</TR>

</TABLE>
</DIV>

<DIV style="margin-top: 6pt">
<TABLE width="100%" border="0" cellpadding="0" cellspacing="0" style="font-size: 10pt">

<TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="3%" style="background: transparent">&nbsp;</TD>
    <TD width="2%" nowrap align="left">(a)</TD>
    <TD width="1%">&nbsp;</TD>
    <TD>Name of Issuer</TD>
</TR>

<TR>
    <TD style="font-size: 6pt">&nbsp;</TD>
</TR><TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="3%" style="background: transparent">&nbsp;</TD>
    <TD width="2%" nowrap align="left"><B>&nbsp;</B></TD>
    <TD width="1%"><B>&nbsp;</B></TD>
    <TD><B>SurModics, Inc.</B></TD>
</TR>

<TR>
    <TD style="font-size: 6pt">&nbsp;</TD>
</TR><TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="3%" style="background: transparent">&nbsp;</TD>
    <TD width="2%" nowrap align="left">(b)</TD>
    <TD width="1%">&nbsp;</TD>
    <TD>Address of Issuer&#146;s Principal Executive Offices</TD>
</TR>

<TR>
    <TD style="font-size: 6pt">&nbsp;</TD>
</TR><TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="3%" style="background: transparent">&nbsp;</TD>
    <TD width="2%" nowrap align="left">&nbsp;</TD>
    <TD width="1%">&nbsp;</TD>
    <TD>&nbsp;<B>9924 West 74th Street, Eden Prairie, MN 55344</B></TD>
</TR>

</TABLE>
</DIV>
<!-- link2 "Item&nbsp;2" -->
<DIV align="left"><A NAME="C62956001"></A></DIV>

<DIV style="margin-top: 6pt">
<TABLE width="100%" border="0" cellpadding="0" cellspacing="0" style="font-size: 10pt">

<TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="2%" nowrap align="left"><B>Item&nbsp;2.</B></TD>
    <TD width="1%">&nbsp;</TD>
    <TD></TD>
</TR>

</TABLE>
</DIV>

<DIV style="margin-top: 6pt">
<TABLE width="100%" border="0" cellpadding="0" cellspacing="0" style="font-size: 10pt">

<TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="3%" style="background: transparent">&nbsp;</TD>
    <TD width="2%" nowrap align="left">(a)</TD>
    <TD width="1%">&nbsp;</TD>
    <TD>Name of Person Filing</TD>
</TR>

<TR>
    <TD style="font-size: 6pt">&nbsp;</TD>
</TR><TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="3%" style="background: transparent">&nbsp;</TD>
    <TD width="2%" nowrap align="left"><B>&nbsp;</B></TD>
    <TD width="1%"><B>&nbsp;</B></TD>
    <TD><B>Dale R. Olseth</B></TD>
</TR>

<TR>
    <TD style="font-size: 6pt">&nbsp;</TD>
</TR><TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="3%" style="background: transparent">&nbsp;</TD>
    <TD width="2%" nowrap align="left">(b)</TD>
    <TD width="1%">&nbsp;</TD>
    <TD>Address of Principal Business Office or, if none, Residence</TD>
</TR>

<TR>
    <TD style="font-size: 6pt">&nbsp;</TD>
</TR><TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="3%" style="background: transparent">&nbsp;</TD>
    <TD width="2%" nowrap align="left"><B>&nbsp;</B></TD>
    <TD width="1%"><B>&nbsp;</B></TD>
    <TD><B>IDS Tower, 80 South Eighth Street, Suite&nbsp;4900, Minneapolis, MN 55402</B></TD>
</TR>

<TR>
    <TD style="font-size: 6pt">&nbsp;</TD>
</TR><TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="3%" style="background: transparent">&nbsp;</TD>
    <TD width="2%" nowrap align="left">(c)</TD>
    <TD width="1%">&nbsp;</TD>
    <TD>Citizenship</TD>
</TR>

<TR>
    <TD style="font-size: 6pt">&nbsp;</TD>
</TR><TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="3%" style="background: transparent">&nbsp;</TD>
    <TD width="2%" nowrap align="left"><B>&nbsp;</B></TD>
    <TD width="1%"><B>&nbsp;</B></TD>
    <TD><B>U.S.A.</B></TD>
</TR>


<TR>
    <TD style="font-size: 6pt">&nbsp;</TD>
</TR><TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="3%" style="background: transparent">&nbsp;</TD>
    <TD width="2%" nowrap align="left">(d)</TD>
    <TD width="1%">&nbsp;</TD>
    <TD>Title of Class of Securities&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</TD>
</TR>

<TR>
    <TD style="font-size: 6pt">&nbsp;</TD>
</TR><TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="3%" style="background: transparent">&nbsp;</TD>
    <TD width="2%" nowrap align="left"><B>&nbsp;</B></TD>
    <TD width="1%"><B>&nbsp;</B></TD>
    <TD><B>Common Stock</B></TD>
</TR>

<TR>
    <TD style="font-size: 6pt">&nbsp;</TD>
</TR><TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="3%" style="background: transparent">&nbsp;</TD>
    <TD width="2%" nowrap align="left">(e)</TD>
    <TD width="1%">&nbsp;</TD>
    <TD>CUSIP Number&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</TD>
</TR>

<TR>
    <TD style="font-size: 6pt">&nbsp;</TD>
</TR><TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="3%" style="background: transparent">&nbsp;</TD>
    <TD width="2%" nowrap align="left">&nbsp;</TD>
    <TD width="1%">&nbsp;</TD>
    <TD>&nbsp;<B>868873-10-0</B></TD>
</TR>

</TABLE>
</DIV>
<!-- link2 "Item&nbsp;3. If this statement is filed pursuant to &#167;&#167;240.13d-1(b) or 240.13d-2(b) or (c), check whether the person filing is a:" -->
<DIV align="left"><A NAME="C62956002"></A></DIV>

<DIV style="margin-top: 6pt">
<TABLE width="100%" border="0" cellpadding="0" cellspacing="0" style="font-size: 10pt">



<TR>
    <TD style="font-size: 6pt">&nbsp;</TD>
</TR><TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="2%" nowrap align="left"><B>Item&nbsp;3.</B></TD>
    <TD width="1%">&nbsp;</TD>
    <TD><B>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;If this statement is filed pursuant to &#167;&#167;240.13d-</B><B>1(b)</B><B> or 240.13d-</B><B>2(b)</B><B> or (c), check whether the person filing is a:</B></TD>
</TR>

</TABLE>
</DIV>
<DIV align="center">
<TABLE style="font-size: 10pt" cellspacing="0" border="0" cellpadding="0" width="100%">
<!-- Begin Table Head -->
<TR valign="bottom">
    <TD width="5%">&nbsp;</TD>
    <TD width="1%">&nbsp;</TD>
    <TD width="3%">&nbsp;</TD>
    <TD width="1%">&nbsp;</TD>
    <TD width="90%">&nbsp;</TD>
</TR>
<TR></TR>
<!-- End Table Head -->
<!-- Begin Table Body -->
<TR valign="bottom">
    <TD align="right" valign="top"><DIV style="margin-left:0px; text-indent:-0px">(a)
</DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="center" valign="top"><FONT style="font-family: Wingdings">&#111;</FONT>
</TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">Broker or dealer registered under section 15 of the Act (15 U.S.C. 78o).</TD>
</TR>
<TR valign="bottom"><!-- Blank Space -->
    <TD align="right" valign="top"><DIV style="margin-left:0px; text-indent:-0px">&nbsp;</DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="center" valign="top">&nbsp;</TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">&nbsp;</TD>
</TR>
<TR valign="bottom">
    <TD align="right" valign="top"><DIV style="margin-left:0px; text-indent:-0px">(b)
</DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="center" valign="top"><FONT style="font-family: Wingdings">&#111;</FONT>
</TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">Bank as defined in section 3(a)(6) of the Act (15 U.S.C. 78c).</TD>
</TR>
<TR valign="bottom"><!-- Blank Space -->
    <TD align="right" valign="top"><DIV style="margin-left:0px; text-indent:-0px">&nbsp;</DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="center" valign="top">&nbsp;</TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">&nbsp;</TD>
</TR>
<TR valign="bottom">
    <TD align="right" valign="top"><DIV style="margin-left:0px; text-indent:-0px">(c)
</DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="center" valign="top"><FONT style="font-family: Wingdings">&#111;</FONT>
</TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">Insurance company as defined in section 3(a)(19) of the Act (15 U.S.C. 78c).</TD>
</TR>
<TR valign="bottom"><!-- Blank Space -->
    <TD align="right" valign="top"><DIV style="margin-left:0px; text-indent:-0px">&nbsp;</DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="center" valign="top">&nbsp;</TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">&nbsp;</TD>
</TR>
<TR valign="bottom">
    <TD align="right" valign="top"><DIV style="margin-left:0px; text-indent:-0px">(d)
</DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="center" valign="top"><FONT style="font-family: Wingdings">&#111;</FONT>
</TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">Investment company registered under section 8 of the Investment Company Act of 1940 (15 U.S.C 80a-8).</TD>
</TR>
<TR valign="bottom"><!-- Blank Space -->
    <TD align="right" valign="top"><DIV style="margin-left:0px; text-indent:-0px">&nbsp;</DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="center" valign="top">&nbsp;</TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">&nbsp;</TD>
</TR>
<TR valign="bottom">
    <TD align="right" valign="top"><DIV style="margin-left:0px; text-indent:-0px">(e)
</DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="center" valign="top"><FONT style="font-family: Wingdings">&#111;</FONT>
</TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">An investment adviser in accordance with &#167;240.13d-1(b)(1)(ii)(E);</TD>
</TR>
<TR valign="bottom"><!-- Blank Space -->
    <TD align="right" valign="top"><DIV style="margin-left:0px; text-indent:-0px">&nbsp;</DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="center" valign="top">&nbsp;</TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">&nbsp;</TD>
</TR>
<TR valign="bottom">
    <TD align="right" valign="top"><DIV style="margin-left:0px; text-indent:-0px">(f)
</DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="center" valign="top"><FONT style="font-family: Wingdings">&#111;</FONT>
</TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">An employee benefit plan or endowment fund in accordance with &#167;240.13d-1(b)(1)(ii)(F);</TD>
</TR>
<TR valign="bottom"><!-- Blank Space -->
    <TD align="right" valign="top"><DIV style="margin-left:0px; text-indent:-0px">&nbsp;</DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="center" valign="top">&nbsp;</TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">&nbsp;</TD>
</TR>
<TR valign="bottom">
    <TD align="right" valign="top"><DIV style="margin-left:0px; text-indent:-0px">(g)
</DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="center" valign="top"><FONT style="font-family: Wingdings">&#111;</FONT>
</TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">A parent holding company or control person in accordance with &#167; 240.13d-1(b)(1)(ii)(G);</TD>
</TR>
<TR valign="bottom"><!-- Blank Space -->
    <TD align="right" valign="top"><DIV style="margin-left:0px; text-indent:-0px">&nbsp;</DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="center" valign="top">&nbsp;</TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">&nbsp;</TD>
</TR>
<TR valign="bottom">
    <TD align="right" valign="top"><DIV style="margin-left:0px; text-indent:-0px">(h)
</DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="center" valign="top"><FONT style="font-family: Wingdings">&#111;</FONT>
</TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">A savings associations as defined in Section&nbsp;3(b) of the Federal Deposit Insurance Act (12 U.S.C. 1813);</TD>
</TR>
<TR valign="bottom"><!-- Blank Space -->
    <TD align="right" valign="top"><DIV style="margin-left:0px; text-indent:-0px">&nbsp;</DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="center" valign="top">&nbsp;</TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">&nbsp;</TD>
</TR>
<TR valign="bottom">
    <TD align="right" valign="top"><DIV style="margin-left:0px; text-indent:-0px">(i)
</DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="center" valign="top"><FONT style="font-family: Wingdings">&#111;</FONT>
</TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">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);</TD>
</TR>
<TR valign="bottom"><!-- Blank Space -->
    <TD align="right" valign="top"><DIV style="margin-left:0px; text-indent:-0px">&nbsp;</DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="center" valign="top">&nbsp;</TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">&nbsp;</TD>
</TR>
<TR valign="bottom">
    <TD align="right" valign="top"><DIV style="margin-left:0px; text-indent:-0px">(j)
</DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="center" valign="top"><FONT style="font-family: Wingdings">&#111;</FONT>
</TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">Group, in accordance with &#167;240.13d-1(b)(1)(ii)(J).</TD>
</TR>
<!-- End Table Body -->
</TABLE>
</DIV>



<DIV style="margin-top: 6pt">
<TABLE width="100%" border="0" cellpadding="0" cellspacing="0" style="font-size: 10pt">

<TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="2%" nowrap align="left"><B>Not applicable</B>.</TD>
    <TD width="1%">&nbsp;</TD>
    <TD></TD>
</TR>






</TABLE>
</DIV>
<P align="center" style="font-size: 10pt"><!-- Folio -->3<!-- /Folio -->
</DIV>

<!-- PAGEBREAK -->
<P><HR noshade><P>
<H5 align="left" style="page-break-before:always"><A HREF="#C62956toc">Table of Contents</A></H5><P>

<DIV style="font-family: 'Times New Roman',Times,serif">


<DIV style="margin-top: 6pt"><TABLE width="100%" border="0" cellpadding="0" cellspacing="0" style="font-size: 10pt">



</TABLE>
</DIV>
<!-- link2 "Item&nbsp;4. Ownership" -->
<DIV align="left"><A NAME="C62956003"></A></DIV>

<DIV style="margin-top: 6pt">
<TABLE width="100%" border="0" cellpadding="0" cellspacing="0" style="font-size: 10pt">

<TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="2%" nowrap align="left"><B>Item&nbsp;4. Ownership</B></TD>
    <TD width="1%">&nbsp;</TD>
    <TD></TD>
</TR>

</TABLE>
</DIV>
<DIV align="left" style="font-size: 10pt; margin-top: 6pt">Provide the following information regarding the aggregate number and percentage of the class of securities of the issuer
identified in Item&nbsp;1.
</DIV>


<DIV style="margin-top: 6pt">
<TABLE width="100%" border="0" cellpadding="0" cellspacing="0" style="font-size: 10pt">

<TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="3%" style="background: transparent">&nbsp;</TD>
    <TD width="2%" nowrap align="left">(a)</TD>
    <TD width="1%">&nbsp;</TD>
    <TD>Amount beneficially owned: <B>760,619</B></TD>
</TR>

<TR>
    <TD style="font-size: 6pt">&nbsp;</TD>
</TR><TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="3%" style="background: transparent">&nbsp;</TD>
    <TD width="2%" nowrap align="left">(b)</TD>
    <TD width="1%">&nbsp;</TD>
    <TD>Percent of class: <B>4.3%</B></TD>
</TR>

<TR>
    <TD style="font-size: 6pt">&nbsp;</TD>
</TR><TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="3%" style="background: transparent">&nbsp;</TD>
    <TD width="2%" nowrap align="left">(c)</TD>
    <TD width="1%">&nbsp;</TD>
    <TD>Number of shares as to which the person has:</TD>
</TR>

</TABLE>
</DIV>

<DIV style="margin-top: 6pt">
<TABLE width="100%" border="0" cellpadding="0" cellspacing="0" style="font-size: 10pt">

<TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="6%" style="background: transparent">&nbsp;</TD>
    <TD width="2%" nowrap align="left">(i)</TD>
    <TD width="1%">&nbsp;</TD>
    <TD>Sole power to vote or to direct the vote <B>760,619</B></TD>
</TR>

<TR>
    <TD style="font-size: 6pt">&nbsp;</TD>
</TR><TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="6%" style="background: transparent">&nbsp;</TD>
    <TD width="2%" nowrap align="left">(ii)</TD>
    <TD width="1%">&nbsp;</TD>
    <TD>Shared power to vote or to direct the vote <b>0</b></TD>
</TR>

<TR>
    <TD style="font-size: 6pt">&nbsp;</TD>
</TR><TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="6%" style="background: transparent">&nbsp;</TD>
    <TD width="2%" nowrap align="left">(iii)</TD>
    <TD width="1%">&nbsp;</TD>
    <TD>Sole power to dispose or to direct the disposition of <B>760,619</B></TD>
</TR>

<TR>
    <TD style="font-size: 6pt">&nbsp;</TD>
</TR><TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="6%" style="background: transparent">&nbsp;</TD>
    <TD width="2%" nowrap align="left">(iv)</TD>
    <TD width="1%">&nbsp;</TD>
    <TD>Shared power to dispose or to direct the disposition of
<b>0</b></TD>
</TR>

</TABLE>
</DIV>
<!-- link2 "Item&nbsp;5. Ownership of Five Percent or Less of a Class" -->
<DIV align="left"><A NAME="C62956004"></A></DIV>

<DIV align="left" style="font-size: 10pt; margin-top: 12pt"><B>Item&nbsp;5. Ownership of Five Percent or Less of a Class</B>
</DIV>

<DIV align="left" style="font-size: 10pt; margin-top: 6pt">If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the
beneficial owner of more than 5% of the class of securities, check
the following <FONT style="font-family: Wingdings">&#254;</FONT>
</DIV>

<!-- link2 "Item&nbsp;6. Ownership of More than Five Percent on Behalf of Another Person" -->
<DIV align="left"><A NAME="C62956005"></A></DIV>

<DIV align="left" style="font-size: 10pt; margin-top: 12pt"><B>Item&nbsp;6. Ownership of More than Five Percent on Behalf of Another Person</B>
</DIV>

<DIV align="left" style="font-size: 10pt; margin-top: 6pt">Not applicable.
</DIV>

<!-- link2 "Item&nbsp;7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company or Control Person" -->
<DIV align="left"><A NAME="C62956006"></A></DIV>

<DIV style="margin-top: 6pt">
<TABLE width="100%" border="0" cellpadding="0" cellspacing="0" style="font-size: 10pt">

<TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="2%" nowrap align="left"><B>Item&nbsp;7.</B></TD>
    <TD width="1%">&nbsp;</TD>
    <TD><B> Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company or Control Person</B></TD>
</TR>

</TABLE>
</DIV>
<DIV align="left" style="font-size: 10pt; margin-top: 6pt">Not applicable.
</DIV>

<!-- link2 "Item&nbsp;8. Identification and Classification of Members of the Group" -->
<DIV align="left"><A NAME="C62956007"></A></DIV>

<DIV align="left" style="font-size: 10pt; margin-top: 12pt"><B>Item&nbsp;8. Identification and Classification of Members of the Group</B>
</DIV>

<DIV align="left" style="font-size: 10pt; margin-top: 6pt">Not applicable.
</DIV>

<!-- link2 "Item&nbsp;9. Notice of Dissolution of Group" -->
<DIV align="left"><A NAME="C62956008"></A></DIV>

<DIV align="left" style="font-size: 10pt; margin-top: 12pt"><B>Item&nbsp;9. Notice of Dissolution of Group</B>
</DIV>

<DIV align="left" style="font-size: 10pt; margin-top: 6pt">Not applicable.
</DIV>

<!-- link2 "Item&nbsp;10. Certification" -->
<DIV align="left"><A NAME="C62956009"></A></DIV>

<DIV align="left" style="font-size: 10pt; margin-top: 12pt"><B>Item&nbsp;10. Certification</B>
</DIV>

<DIV align="left" style="font-size: 10pt; margin-top: 6pt">By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were not acquired and
are not held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were
not acquired and are not held in connection with or as a participant in any transaction having that purpose or effect.
</DIV>








<P align="center" style="font-size: 10pt"><!-- Folio -->4<!-- /Folio -->
</DIV>

<!-- PAGEBREAK -->
<P><HR noshade><P>
<H5 align="left" style="page-break-before:always"><A HREF="#C62956toc">Table of Contents</A></H5><P>


<DIV style="font-family: 'Times New Roman',Times,serif">




<!-- link1 "Signature" -->
<DIV align="left"><A NAME="C62956010"></A></DIV>

<DIV align="center" style="font-size: 10pt; margin-top: 18pt"><B><I>Signature</I></B>
</DIV>

<DIV align="left" style="font-size: 10pt; margin-top: 6pt">After reasonable inquiry and to the best of my knowledge and belief, I certify that the information
set forth in this statement is true, complete and correct.
</DIV>

<DIV align="center">
<TABLE style="font-size: 10pt" cellspacing="0" border="0" cellpadding="0" width="100%">
<!-- Begin Table Head -->
<TR valign="bottom">
    <TD width="47%">&nbsp;</TD>
    <TD width="5%">&nbsp;</TD>
    <TD width="47%">&nbsp;</TD>
</TR>
<TR>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<!-- End Table Head -->
<!-- Begin Table Body -->
<TR valign="bottom">
    <TD align="center" valign="top">&nbsp;
</TD>
    <TD>&nbsp;</TD>
    <TD align="center" valign="top">February 11, 2011</TD>
</TR>
<TR style="font-size: 1px">
    <TD align="left" valign="top">&nbsp;
</TD>
    <TD>&nbsp;</TD>
    <TD align="center" valign="top" style="border-top: 1px solid #000000">&nbsp;</TD>
</TR>
<TR valign="bottom">
    <TD align="left" valign="top">&nbsp;
</TD>
    <TD>&nbsp;</TD>
    <TD align="center" valign="top">Date</TD>
</TR>
<TR valign="bottom"><!-- Blank Space -->
    <TD align="left" valign="top">&nbsp;</TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">&nbsp;</TD>
</TR>
<TR valign="bottom">
    <TD align="left" valign="top">&nbsp;
</TD>
    <TD align="right">By</TD>
    <TD align="center" valign="top">/s/ Dale R. Olseth, by Nancy Olseth, Attorney-in-Fact</TD>
</TR>
<TR style="font-size: 1px">
    <TD align="left" valign="top">&nbsp;
</TD>
    <TD>&nbsp;</TD>
    <TD align="center" valign="top" style="border-top: 1px solid #000000">&nbsp;</TD>
</TR>
<TR valign="bottom">
    <TD align="left" valign="top">&nbsp;
</TD>
    <TD>&nbsp;</TD>
    <TD align="center" valign="top">Signature</TD>
</TR>
<TR valign="bottom"><!-- Blank Space -->
    <TD align="left" valign="top">&nbsp;</TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">&nbsp;</TD>
</TR>
<TR valign="bottom">
    <TD align="left" valign="top">&nbsp;
</TD>
    <TD>&nbsp;</TD>
    <TD align="center" valign="top">Dale R. Olseth</TD>
</TR>
<TR style="font-size: 1px">
    <TD align="left" valign="top">&nbsp;
</TD>
    <TD>&nbsp;</TD>
    <TD align="center" valign="top" style="border-top: 1px solid #000000">&nbsp;</TD>
</TR>
<TR valign="bottom">
    <TD align="left" valign="top">&nbsp;
</TD>
    <TD>&nbsp;</TD>
    <TD align="center" valign="top">Name/Title</TD>
</TR>
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<P align="center" style="font-size: 10pt"><!-- Folio -->5<!-- /Folio -->
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