0001287151-18-000036.txt : 20180201 0001287151-18-000036.hdr.sgml : 20180201 20180201210305 ACCESSION NUMBER: 0001287151-18-000036 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: Staton Mark CENTRAL INDEX KEY: 0001705313 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32498 FILM NUMBER: 18568427 MAIL ADDRESS: STREET 1: C/O XERIUM TECHNOLOGIES, INC. STREET 2: 14101 CAPITAL BOULEVARD CITY: YOUNGSVILLE STATE: NC ZIP: 27596 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_151753697118765.xml FORM 4 X0306 4 2018-01-30 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 2018-01-30 4 A 0 113122 0 A Common Stock 113122.0 113122 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