0001287151-16-000213.txt : 20160803 0001287151-16-000213.hdr.sgml : 20160803 20160803173556 ACCESSION NUMBER: 0001287151-16-000213 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160802 FILED AS OF DATE: 20160803 DATE AS OF CHANGE: 20160803 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Burke Robert Patrick CENTRAL INDEX KEY: 0001679392 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32498 FILM NUMBER: 161804966 MAIL ADDRESS: STREET 1: 14101 CAPITAL BOULEVARD CITY: YOUNGSVILLE STATE: NC ZIP: 27596 4 1 wf-form4_147026014395844.xml FORM 4 X0306 4 2016-08-02 0 0001287151 XERIUM TECHNOLOGIES INC XRM 0001679392 Burke Robert Patrick C/O XERIUM TECHNOLOGIES, INC. 14101 CAPITAL BOULEVARD YOUNGSVILLE NC 27596 0 1 0 0 President - Xerium of Asia Common Stock 2016-08-02 4 A 0 24462 0 A 24467 D Represents a grant of 24,462 stock units ("Stock Units"), comprised of 8,562 time-based restricted stock units ("RSUs") and 15,900 performance-based stock units ("PSUs"). Each Stock Unit represents a contingent right to receive one share of common stock of the Issuer upon vesting of the underlying Stock Unit. The RSUs shall vest on May 4, 2019 and the PSUs shall vest, if at all, upon the attainment of certain performance criteria established by the Board of Directors of the Issuer. Subject to early acceleration and payment under certain circumstances consistent with the terms of the Issuer's 2016-2018 Long Term Incentive Plan and LTIP Share Agreement thereunder, delivery of the common stock underlying the Stock Units is subject to the Reporting Person's continued service to the Issuer through May 4, 2019. This amount represents shares of common stock held by the Reporting Person and shares of common stock underlying Stock Units granted to the Reporting Person. Cliff Pietrafitta, by power of attorney 2016-08-03