SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
AS Investors, LLC

(Last) (First) (Middle)
C/O AMERICAN SECURITIES LLC
299 PARK AVENUE, 34TH FLOOR

(Street)
NEW YORK NY 10171

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
XERIUM TECHNOLOGIES INC [ XRM ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
04/02/2012
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 2,164,338 D(1)(2)
Common Stock 04/02/2012 A(3) 2,171 A $0 8,632(4)(5) D(4)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
1. Name and Address of Reporting Person*
AS Investors, LLC

(Last) (First) (Middle)
C/O AMERICAN SECURITIES LLC
299 PARK AVENUE, 34TH FLOOR

(Street)
NEW YORK NY 10171

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
American Securities Partners V, L.P.

(Last) (First) (Middle)
C/O AMERICAN SECURITIES LLC
299 PARK AVENUE, 34TH FLOOR

(Street)
NEW YORK NY 10171

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director 10% Owner
Officer (give title below) X Other (specify below)
(See Remarks below)
1. Name and Address of Reporting Person*
American Securities Partners V(B), L.P.

(Last) (First) (Middle)
C/O AMERICAN SECURITIES LLC
299 PARK AVE, 34TH FLOOR

(Street)
NEW YORK NY 10171

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director 10% Owner
Officer (give title below) X Other (specify below)
(See Remarks below)
1. Name and Address of Reporting Person*
American Securities Partners V (C) L.P.

(Last) (First) (Middle)
C/O AMERICAN SECURITIES LLC
299 PARK AVE, 34TH FLOOR

(Street)
NEW YORK NY 10171

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director 10% Owner
Officer (give title below) X Other (specify below)
(See Remarks below)
1. Name and Address of Reporting Person*
American Securities Associates V, LLC

(Last) (First) (Middle)
C/O AMERICAN SECURITIES LLC
299 PARK AVE., 34TH FLOOR

(Street)
NEW YORK NY 10171

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director 10% Owner
Officer (give title below) X Other (specify below)
(See Remarks below)
1. Name and Address of Reporting Person*
AMERICAN SECURITIES LLC

(Last) (First) (Middle)
299 PARK AVENUE
34TH FLOOR

(Street)
NEW YORK NY 10171

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director 10% Owner
Officer (give title below) X Other (specify below)
(See Remarks below)
1. Name and Address of Reporting Person*
Saiontz Marc

(Last) (First) (Middle)
C/O XERIUM TECHNOLOGIES, INC.
8537 SIX FORKS ROAD, SUITE 300

(Street)
RALEIGH NC 27615

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
X Director 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
1. The shares are directly owned by AS Investors, LLC and may also be deemed to be indirectly beneficially owned by: (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, LLC; (ii) American Securities Associates V, LLC ("GP"), the general partner of each Sponsor; and (iii) American Securities LLC ("ASL"), which provides investment advisory services to each Sponsor and GP.
2. Each 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.
3. Grant of stock (immediate vesting of Director Deferred Stock Units).
4. Marc Saiontz is a managing director of ASL (and a director of Xerium Technologies, Inc. (the "Issuer")). Pursuant to an arrangement between Mr. Saiontz and ASL, all director fees received by him from the Issuer are paid over to or held for the benefit of ASL.
5. Includes 2,228 Director Deferred Stock Units and 6,404 shares of Common Stock.
Remarks:
Exhibit 99.1 Joint Filer Information incorporated herein by reference
/s/ Marc Saiontz 04/03/2012
AS Investors, LLC By: /s/ Marc Saiontz, as Vice President 04/03/2012
American Securities Partners V, L.P. By: American Securities Associates V, LLC, its general partner By: /s/ Michael G. Fisch, as Managing Member 04/03/2012
American Securities Partners V(B), L.P. By: American Securities Associates V, LLC, its general partner By: /s/ Michael G. Fisch, as Managing Member 04/03/2012
American Securities Partners V(C), L.P. By: American Securities Associates V, LLC, its general partner By: /s/ Michael G. Fisch, as Managing Member 04/03/2012
American Securities Associates V, LLC By: /s/ Michael G. Fisch, as Managing Member 04/03/2012
American Securities LLC By: /s/ Michael G. Fisch, as President and Chief Executive Officer 04/03/2012
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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