0001209191-18-009997.txt : 20180214 0001209191-18-009997.hdr.sgml : 20180214 20180214172333 ACCESSION NUMBER: 0001209191-18-009997 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171231 FILED AS OF DATE: 20180214 DATE AS OF CHANGE: 20180214 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: TAMBAKERAS MARKOS I CENTRAL INDEX KEY: 0001012990 STANDARD INDUSTRIAL CLASSIFICATION: AUTO CONTROLS FOR REGULATING RESIDENTIAL & COMML ENVIRONMENT [3822] STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35229 FILM NUMBER: 18613815 MAIL ADDRESS: STREET 1: C/O ITT CORPORATION STREET 2: 1133 WESTCHESTER AVENUE CITY: WHITE PLAINS STATE: NY ZIP: 10604 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Xylem Inc. CENTRAL INDEX KEY: 0001524472 STANDARD INDUSTRIAL CLASSIFICATION: PUMPS & PUMPING EQUIPMENT [3561] IRS NUMBER: 452080495 STATE OF INCORPORATION: IN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1 INTERNATIONAL DRIVE CITY: RYE BROOK STATE: NY ZIP: 10573 BUSINESS PHONE: 914-304-1700 MAIL ADDRESS: STREET 1: 1 INTERNATIONAL DRIVE CITY: RYE BROOK STATE: NY ZIP: 10573 FORMER COMPANY: FORMER CONFORMED NAME: ITT WCO, Inc. DATE OF NAME CHANGE: 20110628 5 1 doc5.xml FORM 5 SUBMISSION X0306 5 2017-12-31 0 0 0 0001524472 Xylem Inc. XYL 0001012990 TAMBAKERAS MARKOS I 1 INTERNATIONAL DRIVE C/O XYLEM INC. RYE BROOK NY 10573 1 0 0 0 Common Stock 2017-08-23 5 G 0 9512 0.00 D 35070 D Common Stock 2017-08-23 5 G 0 9512 0.00 A 27964 I By Tambakeras Family Trust On August 23, 2017, 9512 shares of Xylem Inc. common stock were gifted to the reporting person's revocable family trust. /s/ Juliene Patton, by power of attorney for Markos I. Tambakeras 2018-02-14