1. Name and Address of Reporting Person*
C/O AMERICAN SECURITIES LLC |
299 PARK AVE., 34TH FLOOR |
(Street)
|
2. Issuer Name and Ticker or Trading Symbol
XERIUM TECHNOLOGIES INC
[ XRM ]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
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3. Date of Earliest Transaction
(Month/Day/Year) 10/22/2010
|
4. If Amendment, Date of Original Filed
(Month/Day/Year)
|
6. Individual or Joint/Group Filing (Check Applicable Line)
|
Form filed by One Reporting Person |
X |
Form filed by More than One Reporting Person |
|
1. Name and Address of Reporting Person*
C/O AMERICAN SECURITIES LLC |
299 PARK AVE., 34TH FLOOR |
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
1. Name and Address of Reporting Person*
C/O AMERICAN SECURITIES LLC |
299 PARK AVENUE, 34TH FLOOR |
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
1. Name and Address of Reporting Person*
C/O AMERICAN SECURITIES LLC |
299 PARK AVE, 34TH FLOOR |
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
1. Name and Address of Reporting Person*
C/O AMERICAN SECURITIES LLC |
299 PARK AVE, 34TH FLOOR |
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
1. Name and Address of Reporting Person*
C/O AMERICAN SECURITIES LLC |
299 PARK AVE., 34TH FLOOR |
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
1. Name and Address of Reporting Person*
299 PARK AVENUE |
34TH FLOOR |
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
1. Name and Address of Reporting Person*
C/O XERIUM TECHNOLOGIES, INC. |
8537 SIX FORKS ROAD, SUITE 300 |
(Street)
Relationship of Reporting Person(s) to Issuer
X |
Director |
|
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
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AS Investors, LLC By: /s/ Marc Saiontz, as Vice President |
10/26/2010 |
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American Securities Partners V, L.P. By: American Securities Associates V, LLC, its general partner By: /s/ Michael G. Fisch, as Managing Member |
10/26/2010 |
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American Securities Partners V(B), L.P. By: American Securities Associates V, LLC, its general partner By: /s/ Michael G. Fisch, as Managing Member |
10/26/2010 |
|
American Securities Partners V(C), L.P. By: American Securities Associates V, LLC, its general partner By: /s/ Michael G. Fisch, as Managing Member |
10/26/2010 |
|
American Securities Associates V, LLC By: /s/ Michael G. Fisch, as Managing Member |
10/26/2010 |
|
American Securities LLC By: /s/ Michael G. Fisch, as President and Chief Executive Officer |
10/26/2010 |
|
/s/ Marc Saiontz |
10/26/2010 |
|
** 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. |
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. |