0001209191-21-032344.txt : 20210513 0001209191-21-032344.hdr.sgml : 20210513 20210513163102 ACCESSION NUMBER: 0001209191-21-032344 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210512 FILED AS OF DATE: 20210513 DATE AS OF CHANGE: 20210513 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gomez Jorge M CENTRAL INDEX KEY: 0001726653 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35229 FILM NUMBER: 21920117 MAIL ADDRESS: STREET 1: C/O DENTSPLY SIRONA INC STREET 2: 13320 BALLANTYNE CORPORATE PLACE CITY: CHARLOTTE STATE: NC ZIP: 28277 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Xylem Inc. CENTRAL INDEX KEY: 0001524472 STANDARD INDUSTRIAL CLASSIFICATION: PUMPS & PUMPING EQUIPMENT [3561] IRS NUMBER: 452080495 STATE OF INCORPORATION: IN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1 INTERNATIONAL DRIVE CITY: RYE BROOK STATE: NY ZIP: 10573 BUSINESS PHONE: 914-323-5700 MAIL ADDRESS: STREET 1: 1 INTERNATIONAL DRIVE CITY: RYE BROOK STATE: NY ZIP: 10573 FORMER COMPANY: FORMER CONFORMED NAME: ITT WCO, Inc. DATE OF NAME CHANGE: 20110628 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-05-12 0 0001524472 Xylem Inc. XYL 0001726653 Gomez Jorge M XYLEM INC. 1 INTERNATIONAL DRIVE RYE BROOK NY 10523 1 0 0 0 Common Stock 2021-05-12 4 A 0 1328 0.00 A 5758 D Reflects the award of restricted stock units. The Reporting Person elected to defer the vesting of the RSU Award until Separation from Service. Amount shown reflects additional shares acquired via a dividend reinvestment plan or DRIP. /s/ Kimberly Rehm, by power of attorney for Jorge M. Gomez. 2021-05-13