0001287151-18-000114.txt : 20181017 0001287151-18-000114.hdr.sgml : 20181017 20181017160933 ACCESSION NUMBER: 0001287151-18-000114 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20181017 FILED AS OF DATE: 20181017 DATE AS OF CHANGE: 20181017 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MCGOVERN JOHN F CENTRAL INDEX KEY: 0001090723 STANDARD INDUSTRIAL CLASSIFICATION: LUMBER & WOOD PRODUCTS (NO FURNITURE) [2400] STATE OF INCORPORATION: GA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32498 FILM NUMBER: 181126506 MAIL ADDRESS: STREET 1: 3231 SE SIXTH AVENUE CITY: TOPEKA STATE: KS ZIP: 66607 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: XERIUM TECHNOLOGIES INC CENTRAL INDEX KEY: 0001287151 STANDARD INDUSTRIAL CLASSIFICATION: BROADWOVEN FABRIC MILS, MAN MADE FIBER & SILK [2221] IRS NUMBER: 421558674 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 14101 CAPITAL BOULEVARD CITY: YOUNGSVILLE STATE: NC ZIP: 27596 BUSINESS PHONE: 919-526-1400 MAIL ADDRESS: STREET 1: 14101 CAPITAL BOULEVARD CITY: YOUNGSVILLE STATE: NC ZIP: 27596 4 1 wf-form4_153980695730233.xml FORM 4 X0306 4 2018-10-17 1 0001287151 XERIUM TECHNOLOGIES INC XRM 0001090723 MCGOVERN JOHN F C/O XERIUM TECHNOLOGIES, INC. 14101 CAPITAL BOULEVARD YOUNGSVILLE NC 27596 1 0 0 0 Common Stock 2018-10-17 4 D 0 82285 13.50 D 0 D Represents the conversion of outstanding shares of common stock of Xerium Technologies, Inc. (the "Company") and vested director deferred stock units into the right to receive $13.50 per share or unit in connection with the merger of the Company with an indirect wholly owned subsidiary of Andritz AG on October 17, 2018, pursuant to an Agreement and Plan of Merger dated June 24, 2018. /s/ Phillip Kennedy, by power of attorney 2018-10-17