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
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1. Name and Address of Reporting Person*
Peery Kimberly R.

(Last) (First) (Middle)
C/O STEREOTAXIS, INC.
4320 FOREST PARK AVENUE, SUITE 100

(Street)
ST. LOUIS, MO 63108

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
10/01/2019
3. Issuer Name and Ticker or Trading Symbol
Stereotaxis, Inc. [ STXS ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Financial Officer
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)
Common Stock 945 D
Common Stock 3,750(1) D
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 Appreciation Rights 03/27/2015(2) 03/26/2024 Common Stock 4,000 4.04 D
Stock Options (Right to Buy) 02/26/2019(3) 03/25/2028 Common Stock 15,750 0.74 D
Stock Options (Right to Buy) 03/03/2020(4) 03/02/2029 Common Stock 35,000 2.03 D
Explanation of Responses:
1. Unvested restricted share units granted on 2/09/16. Each restricted share unit represents a right to receive one share of common stock. The restricted share units vest over a four year period in equal installments of 25%, each occurring on the anniversary date of the grant.
2. Stock appreciation rights granted on 3/27/14 of which 4,000 are outstanding and vested.
3. Stock options granted on 2/26/18 of which 647 are vested with the remaining vesting ratably per month through 02/29/2022.
4. Stock options granted on 3/03/19, none of which are vested. The stock options vest as follows: (1) 25% vest one year after the date of the grant (2) the remaining 75% vest ratably per month over the next three years.
/s/ Kimberly R. Peery 10/02/2019
** 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.