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
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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*
MCKAY SAMUEL F

(Last) (First) (Middle)
C/O ANIKA THERAPEUTICS, INC.
160 NEW BOSTON STREET

(Street)
WOBURN MA 01801

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
ANIKA THERAPEUTICS INC [ ANIK ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
11/11/2004
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
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 11/11/2004 M 2,000 A $7.625 2,000 I(1) By General Partner
Common Stock 11/11/2004 M 1,596 A $9.75 3,596 I(1) By General Partner
Common Stock 11/11/2004 M 11,800 A $1.05 15,396 I(1) By General Partner
Common Stock 11/11/2004 S 1,200 D $9.6308 14,196 I(1) By General Partner
Common Stock 11/12/2004 S 3,500 D $9.5562 10,696 I(1) By General Partner
Common Stock 1,874 D
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 Purchase) $7.625 11/11/2004 M 2,000 02/28/1998 02/28/2008 Common Stock 2,000 $7.625 0(2) D
Stock Option (Right to Purchase) $9.75 11/11/2004 M 1,596 03/27/2000 03/27/2010 Common Stock 1,596 $9.75 0(2) D
Stock Option (Right to Purchase) $1.05 11/11/2004 M 11,800 03/21/2002 03/21/2012 Common Stock 11,800 $1.05 0(2) D
Explanation of Responses:
1. The reporting person disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein which is less than 10%.
2. Pursuant to a pre-existing agreement with Axiom Venture Partners Limited Partnership (Axiom), of which the reporting person is a general partner, the economic interest in the shares of Anika common stock underlying these stock options were to be held for the benefit of Axiom. Accordingly, Axiom took possession of the shares of Anika common stock immediately following the exercise of the stock options by the registrant.
/s/ Samuel F. McKay 11/15/2004
** 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.
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