SEC Form 4/A · accession 0001287151-15-000094
XERIUM TECHNOLOGIES INC · XRM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Aug 15, 2015 | F | 160,908 | $14.88 | D | 836,054 | D | |
| Common StockF2,F3 | Aug 15, 2015 | F | 32,466 | $14.88 | D | 803,588 | D |
Table II — derivative securities
Explanation of responses
- F1Represents 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.
- F2Represents 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.
- F3Includes 269,979 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.
Remarks
This Form 4 Amendment is being filed to correct tax withholding calculation errors in connection with the transactions identified above. The number of 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 was corrected from 161,956 to 160,908. The number of shares withheld in satisfaction of the withholding tax liability in connection with the issuance of shares of common stock underlying outstanding Restricted Stock Units granted to Mr. Bevis when he joined the Company was corrected from 32,841 to 32,466. The number of shares of common stock noted as being held by Mr. Bevis in footnote 4 of the original Form 4 filing increased from 268,556 to 269,979 (as indicated in footnote 3 above).