SEC Form 4 · accession 0001287151-15-000092
XERIUM TECHNOLOGIES INC · XRM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
A later amendment supersedes this filing — read the amendment. The figures below are kept as originally reported (version chain, not an overwrite).
Reporting owner
Harold C Bevis
Officer — President & CEO · Director
Period of report
Aug 15, 2015
Accepted (ET)
Aug 18, 2015 · 6:15 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 | Aug 15, 2015 | M | 260,540 | $4.00 | A | 996,962 | D | |
| Common StockF2 | Aug 15, 2015 | F | 161,956 | $14.88 | D | 835,006 | D | |
| Common StockF3,F4 | Aug 15, 2015 | F | 32,841 | $14.88 | D | 802,165 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Employee Common Stock Options (right to buy)F5 | $4.00 | Aug 15, 2015 | M | 260,540 | D | Aug 15, 2015 | Aug 15, 2022 | Common Stock | 260,540 | 260,621 | D |
Explanation of responses
- F1Represents gross number of shares underlying the Employee Common Stock Options exercised by Mr. Bevis. These Options were granted to Mr. Bevis as sign-on awards when Mr. Bevis joined the Company.
- F2Represents shares withheld in satisfaction of the $4.00 Employee Common Stock Option exercise price and the withholding tax liability in connection with the issuance of shares of common stock underlying the Employee Common Stock Option.
- F3Represents shares withheld in satisfaction of the withholding tax liability in connection with the issuance of shares of common stock underlying outstanding Restricted Stock Units. The Restricted Stock Units were granted to Mr. Bevis as sign-on awards when Mr. Bevis joined the Company.
- F4Includes 268,556 shares of common stock held by Mr. Bevis and 533,609 Restricted Stock Units that will be converted into shares of common stock, less tax withholdings, upon the satisfaction of all performance and time-based vesting conditions applicable to such Restricted Stock Units.
- F5The remaining portion of the Employee Common Stock Options vests on August 15, 2016.