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
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
  
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*
MCCAUSLAND BONNIE F

(Last) (First) (Middle)
C/O AIRGAS, INC.
259 N. RADNOR-CHESTER ROAD, SUITE 100

(Street)
RADNOR PA 19087

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
AIRGAS INC [ ARG ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
05/10/2004
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X 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 05/10/2004 M 54,000 A $11.32 54,000(1) I Trust FBO Children
Common Stock 05/10/2004 M 108,000 A $14.71 162,000(1) I Trust FBO Children
Common Stock 9,481,026(2) D
Common Stock 397,468(3) I Immediate Family
Common Stock 40,611(4) I 401(k) Plan
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
Stock Option (Right to Buy) $11.32 05/10/2004 M 54,000 05/10/2004 05/12/2004 Common Stock 54,000 (5) 0 I Trust FBO Children
Stock Option (Right to Buy) $14.71 05/10/2004 M 108,000 05/10/2004 05/12/2004 Common Stock 108,000 (5) 0 I Trust FBO Children
1. Name and Address of Reporting Person*
MCCAUSLAND BONNIE F

(Last) (First) (Middle)
C/O AIRGAS, INC.
259 N. RADNOR-CHESTER ROAD, SUITE 100

(Street)
RADNOR PA 19087

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
MCCAUSLAND PETER

(Last) (First) (Middle)
C/O AIRGAS, INC.
259 N. RADNOR-CHESTER ROAD, SUITE 100

(Street)
RADNOR PA 19087

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
X Director X 10% Owner
X Officer (give title below) Other (specify below)
Chairman of the Board and CEO
Explanation of Responses:
1. Represents shares of Airgas, Inc. common stock beneficially owned by the reporting person as trustee of a trust for the benefit of the reporting person's children.
2. Includes 1,500 shares owned directly by Bonnie F. McCausland and indirectly by Peter McCausland and 1,500,000 shares subject to a pre-paid variable share forward contract.
3. Includes 15,700 shares owned directly by Peter McCausland and indirectly by Bonnie F. McCausland.
4. Represents shares of Airgas, Inc. common stock held in Peter McCausland's 401(k) plan and beneficially owned indirectly by Bonnie McCausland.
5. Not applicable.
Remarks:
Todd R. Craun, Attorney-in-Fact for Bonnie F. McCausland 05/12/2004
Todd R. Craun, Attorney-in-Fact for Peter McCausland 05/12/2004
** 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.