0001287151-17-000065.txt : 20170601 0001287151-17-000065.hdr.sgml : 20170601 20170601171341 ACCESSION NUMBER: 0001287151-17-000065 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170530 FILED AS OF DATE: 20170601 DATE AS OF CHANGE: 20170601 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: Staton Mark CENTRAL INDEX KEY: 0001705313 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32498 FILM NUMBER: 17885615 MAIL ADDRESS: STREET 1: C/O XERIUM TECHNOLOGIES, INC. STREET 2: 14101 CAPITAL BOULEVARD CITY: YOUNGSVILLE STATE: NC ZIP: 27596 4 1 wf-form4_149635160732574.xml FORM 4 X0306 4 2017-05-30 0 0001287151 XERIUM TECHNOLOGIES INC XRM 0001705313 Staton Mark C/O XERIUM TECHNOLOGIES, INC. 14101 CAPITAL BOULEVARD YOUNGSVILLE NC 27596 1 1 0 0 President and CEO Phantom Stock Unit 2017-05-30 4 A 0 72886 0 A Common Stock 72886.0 72886 D Each Phantom Stock Unit is the economic equivalent of one share of Xerium Technologies, Inc. common stock. Subject to time and performance conditions and early vesting in limited circumstances, on 5/30/2020, the Phantom Stock Units will be settled in cash equal to the average closing price of the common stock for the 30-days preceding 5/30/2020. No shares of common stock will be issued in connection with the settlement of the Phantom Stock Units. /s/ Phillip Kennedy, by power of attorney 2017-06-01