0001287151-18-000029.txt : 20180201 0001287151-18-000029.hdr.sgml : 20180201 20180201210102 ACCESSION NUMBER: 0001287151-18-000029 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180130 FILED AS OF DATE: 20180201 DATE AS OF CHANGE: 20180201 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Bly Michael CENTRAL INDEX KEY: 0001575017 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32498 FILM NUMBER: 18568418 MAIL ADDRESS: STREET 1: C/O XERIUM TECHNOLOGIES, INC. STREET 2: 8537 SIX FORKS RD., SUITE 300 CITY: RALEIGH STATE: NC ZIP: 27615 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_151753684754083.xml FORM 4 X0306 4 2018-01-30 0 0001287151 XERIUM TECHNOLOGIES INC XRM 0001575017 Bly Michael C/O XERIUM TECHNOLOGIES, INC. 14101 CAPITAL BOULEVARD YOUNGSVILLE NC 27596 0 1 0 0 EVP of Global Human Resources Phantom Stock Unit 2018-01-30 4 A 0 44118 0 A Common Stock 44118.0 44118 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 1/30/2021, the Phantom Stock Units will be settled in cash equal to the average closing price of the common stock for the 30-days preceding 1/30/2021. 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 2018-02-01