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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | 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 control number. | SEC 2270 (9-02) |
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 Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned at End of Issuer's Fiscal Year (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
MCCAUSLAND PETER C/O AIRGAS, INC. 259 N. RADNOR-CHESTER RD., STE. 100 RADNOR, PA 19087 |
 X |  X |  Chairman of the Board and CEO |  |
MCCAUSLAND BONNIE F C/O AIRGAS, INC. 259 N. RADNOR-CHESTER RD. RADNOR, PA 19087 |
 |  X |  |  |
Dean A. Bertolino, Attorney-in-Fact for Peter McCausland | 05/11/2006 | |
**Signature of Reporting Person | Date | |
Dean A. Bertolino, Attorney-in-Fact for Bonnie F. McCausland | 05/11/2006 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | Not applicable. |
(2) | Includes 15,700 shares owned directly by Peter McCausland and indirectly by Bonnie F. McCausland. |
(3) | The 12,723 shares of Airgas, Inc. common stock that are the subject of this gift by the Peter McCausland have been reflected as disposed of by the reporting person under column 5 of the reporting person's Form 4 filed on September 22, 2005. |
(4) | Does not include 40,000 shares of Airgas, Inc. common stock transferred by Peter McCausland to his spouse, Bonnie McCausland, on December 15, 2005. |
(5) | Includes 41,500 shares owned directly by Bonnie F. McCausland and indirectly by Peter McCausland. |
(6) | The information presented is as of March 31, 2006, the date of the latest available statement of the reporting person's holdings of Airgas, Inc. common stock in his 401(k) plan. Since September 13, 2005, the date relied upon for the amount reported on Peter McCausland's Form 4 dated September 22, 2005, a total of 495 shares have been acquired in transactions exempt from Section 16(b) by Rule 19b-3(c). |