0001287151-18-000119.txt : 20181017 0001287151-18-000119.hdr.sgml : 20181017 20181017161301 ACCESSION NUMBER: 0001287151-18-000119 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: Burke Robert Patrick CENTRAL INDEX KEY: 0001679392 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32498 FILM NUMBER: 181126527 MAIL ADDRESS: STREET 1: 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_153980716610848.xml FORM 4 X0306 4 2018-10-17 1 0001287151 XERIUM TECHNOLOGIES INC XRM 0001679392 Burke Robert Patrick C/O XERIUM TECHNOLOGIES, INC. 14101 CAPITAL BOULEVARD YOUNGSVILLE NC 27596 0 1 0 0 President - Asia Common Stock 2018-10-17 4 D 0 24467 13.50 D 0 D Phantom Stock Unit 2018-10-17 4 D 0 33937 13.50 D Common Stock 33937.0 0 D Phantom Stock Unit 2018-10-17 4 D 0 21866 13.50 D Common Stock 21866.0 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. Phillip Kennedy, by power of attorney 2018-10-17