SEC Form 4 · accession 0001140361-17-036645
XERIUM TECHNOLOGIES INC · XRM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owners
American Securities Partners V, L.P.
10% Owner
AMERICAN SECURITIES LLC
10% Owner
AS Investors, LLC
10% Owner
Period of report
Sep 25, 2017
Accepted (ET)
Sep 27, 2017 · 4:57 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001287151
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2,F3 | Sep 25, 2017 | J | 781,735 | — | D | 1,395,532 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1The Sponsors (as defined below) made an in-kind distribution to their respective limited partners for no consideration.
- F2As of September 25, 2017, AS Investors, LLC ("AS Investors") was the direct record owner of 1,382,603 shares of common stock of Xerium Technologies Inc. ("Xerium"). As a result of their relationship to AS Investors, (i) American Securities Partners V, L.P., American Securities Partners V(B), L.P. and American Securities Partners V(C), L.P. (each, a "Sponsor"), the owners of membership interests in AS Investors; (ii) American Securities Associates V, LLC ("GP"), the general partner of each Sponsor; and (iii) American Securities LLC ("Advisor"), which provides investment advisory services to each Sponsor and GP may also be deemed to be beneficial owners of Xerium. Additionally, as of September 25, 2017, Advisor directly owns 12,929 shares of common stock. Accordingly, as of September 25, 2017, Advisor may be deemed to be the beneficial owner of an aggregate of 1,395,532 shares of common stock of Xerium.
- F3Each Reporting Person disclaims beneficial ownership of the reported securities except to the extent of such Reporting Person's pecuniary interest therein, and this report shall not be deemed an admission that such Reporting Person is the beneficial owner of the securities for purposes of Section 16 of the Securities Exchange Act of 1934, as amended, or for any other purpose.
Remarks
Exhibit 99.1 Joint Filer Information incorporated herein by reference