0001287151-18-000118.txt : 20181017
0001287151-18-000118.hdr.sgml : 20181017
20181017161225
ACCESSION NUMBER: 0001287151-18-000118
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20181017
FILED AS OF DATE: 20181017
DATE AS OF CHANGE: 20181017
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: 181126524
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_153980712939315.xml
FORM 4
X0306
4
2018-10-17
1
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
2018-10-17
4
D
0
61032
13.50
D
0
D
Phantom Stock Unit
2018-10-17
4
D
0
44118
13.50
D
Common Stock
44118.0
0
D
Phantom Stock Unit
2018-10-17
4
D
0
28426
13.50
D
Common Stock
28426.0
0
D
Represents the conversion of outstanding shares of common stock of Xerium Technologies, Inc. (the "Company") and restricted stock units underlying the Company's 2016 Long-Term Incentive Plan, in each case, into the right to receive $13.50 per share or unit in connection with the merger of the Company with an indirect wholly owned subsidiary of Andritz AG on October 17, 2018 (the "Merger"), pursuant to an Agreement and Plan of Merger dated June 24, 2018.
Each Phantom Stock Unit ("2018 Units") is the economic equivalent of one share of the Company's common stock and was awarded pursuant to the Company's 2018 Long-Term Incentive Plan. In connection with the Merger, on October 17, 2018, the 2018 Units vested and were converted into the right to receive 13.50 per unit.
Each Phantom Stock Unit ("2017 Units") is the economic equivalent of one share of the Company's common stock and was awarded pursuant to the Company's 2017 Long-Term Incentive Plan. In connection with the Merger, on October 17, 2018, the 2017 Units vested and were converted into the right to receive $13.50 per unit.
/s/ Phillip Kennedy, by power of attorney
2018-10-17