SEC FORM 3 SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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: 3235-0104
Estimated average burden
hours per response: 0.5
1. Name and Address of Reporting Person*
Mills William C. III

(Last) (First) (Middle)
626 SCHOOL STREET

(Street)
CARLISLE MA 01741

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
08/11/2004
3. Issuer Name and Ticker or Trading Symbol
Stereotaxis, Inc. [ STXS ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
5. 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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (right to buy) 11/01/2002 11/01/2010 Common Stock 6,944 0.79 D
Stock Option (right to buy) 03/25/2003 03/25/2012 Common Stock 8,333 4.75 D
Stock Option (right to buy) 09/25/2003 09/25/2012 Common Stock 6,250 5.94 D
Stock Option (right to buy) 09/23/2004 09/23/2013 Common Stock 6,250 5.94 D
Stock Option (right to buy) 05/26/2005 05/26/2014 Common Stock 6,250 7.02 D
Series D Convertible Preferred Stock (1) (1) Common Stock 640 (2) I Advent Partners HLS II Limited Partnership(3)
Series D Convertible Preferred Stock (1) (1) Common Stock 3,200 (2) I Advent Partners Limited Partnership(3)
Series D-1 Convertible Preferred Stock (1) (1) Common Stock 192 (2) I Advent Partners HLS II Limited Partnership(3)
Series D-1 Convertible Preferred Stock (1) (1) Common Stock 960 (2) I Advent Partners Limited Partnership(3)
Series D-2 Convertible Preferred Stock (1) (1) Common Stock 128 (2) I Advent Partners HLS II Limited Partnership(3)
Series D-2 Convertible Preferred Stock (1) (1) Common Stock 640 (2) I Advent Partners Limited Partnership(3)
Series D-1 Common Stock Warrants 11/21/2001 11/21/2006 Common Stock 29 7.81 I Advent Partners HLS II Limited Partnership(3)
Series D-1 Common Stock Warrants 11/21/2001 11/21/2006 Common Stock 144 7.81 I Advent Partners Limited Partnership(3)
Series D-2 Common Stock Warrants 12/17/2002 12/31/2007 Common Stock 19 7.81 I Advent Partners HLS II Limited Partnership(3)
Series D-2 Common Stock Warrants 12/17/2002 12/31/2007 Common Stock 96 7.81 I Advent Partners Limited Partnership(3)
Explanation of Responses:
1. All Series of the Company's Convertible Preferred Stock are convertible upon demand at any time.
2. 1-for-3.6.
3. These shares are indirectly beneficially owned as a limited partner.
/s/ William C. Mills III 08/04/2004
** 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 5 (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.

Innovation Day