0001287151-18-000053.txt : 20180306 0001287151-18-000053.hdr.sgml : 20180306 20180306171922 ACCESSION NUMBER: 0001287151-18-000053 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180302 FILED AS OF DATE: 20180306 DATE AS OF CHANGE: 20180306 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: 18670934 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_152037474899389.xml FORM 4 X0306 4 2018-03-02 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 Common Stock 2018-03-02 4 F 0 1434 5.90 D 61032 D Represents shares withheld by the Company to satisfy tax withholding obligations upon vesting and delivery of shares underlying performance-based and time-based Restricted Stock Units granted under the Company's 2015 Long-Term Incentive Plan ("2015 LTIP"). In addition to the number of shares withheld to satisfy tax withholding obligations, the number of shares of common stock reported herein as beneficially owned has been decreased by an additional 2,767 to reflect the forfeiture of Restricted Stock Units originally granted under the 2015 LTIP. /s/ Phillip Kennedy, by power of attorney 2018-03-06