X0201 4 2004-01-05 0 0001084726 MEDSOURCE TECHNOLOGIES INC MEDT 0001094331 CIFFOLILLO JOSEPH A C/O MEDSOURCE TECHNOLOGIES, INC. 110 CHESHIRE LANE, SUITE 100 MINNEAPOLIS MN 55305 1 0 0 0 Common Stock 2004-01-05 4 A 0 694 A 17694 D Common Stock 28178 I By River Edge Partners, Inc. The shares were issued to the reporting person as payment of director's fees for the fiscal quarter ended December 31, 2003, and the price per share used in determining the amount of shares issued to the reporting person was the closing price of the issuer's shares on the Nasdaq National Market on December 31, 2003. The shares are beneficially owned by River Edge Partners, Inc. The reporting person disclaims beneficial ownership of such shares, and this report shall not be an admission that the reporting person is the beneficial owner of such shares for purposes of Section 16 or for any other purpose, except to the extent of his pecuniary interest. /s/ William Kullback, Attorney-in-fact 2004-01-05