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*
Simmons Annette C

(Last) (First) (Middle)
5430 LBJ FREEWAY, SUITE 1700

(Street)
DALLAS TX 75240

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
09/01/2004
3. Issuer Name and Ticker or Trading Symbol
TITANIUM METALS CORP [ TIE ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 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)
Common Stock, par value $0.01 per share 8,364,310 I by Spouse(1)
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
6 3/4% Series A Convertible Preferred Stock (2) (3) Common Stock, par value $0.01 per share 2,666,666 (4) D
6 3/4% Series A Convertible Preferred Stock (2) (3) Common Stock, par value $0.01 per share 24,500 (4) I by Spouse(1)
Explanation of Responses:
1. Directly or indirectly beneficially owned by Harold C. Simmons, the reporting person's spouse. The reporting person disclaims beneficial ownership of all of these securities. See Additional Information filed as Exhibit 99 to this statement for a description of how these securities are held.
2. Exercisable immediately.
3. Not applicable.
4. The 6 3/4% Series A Convertible Preferred stock, par value $0.01 per share ("Series A Preferred Stock"), of the issuer is convertible in shares of the issuer's common stock at the rate of one share of Series A Preferred Stock for one and two-thirds shares of the issuer's common stock.
Remarks:
Exhibit Index 24 Power of Attorney executed by Annette C. Simmons 99 Additional Information
A. Andrew R. Louis, Attorney-in-Fact for Annette C. Simmons 09/03/2004
** 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.