10-12B/A 1 y91930a2e10v12bza.htm FORM 10-12B/A e10v12bza
As filed with the Securities and Exchange Commission on September 13, 2011
 
File No. 001-35229
 
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
 
Amendment No. 2
to
 
Form 10
 
     
GENERAL FORM FOR REGISTRATION OF SECURITIES PURSUANT TO SECTION 12(b) OR 12(g) OF THE SECURITIES EXCHANGE ACT OF 1934
 
 
Xylem Inc.
(Exact name of registrant as specified in its charter)
 
 
     
Indiana
  45-2080495
(State or other jurisdiction of
incorporation or organization)
  (I.R.S. Employer
Identification No.)
     
1133 Westchester Avenue, Suite 2000
White Plains, New York
(Address of Principal Executive Offices)
  10604
(Zip Code)
 
 
Registrant’s telephone number, including area code:
(914) 304-1700
 
Securities to be registered pursuant to Section 12(b) of the Act:
 
     
    Name of Each Exchange on Which
Title of Each Class to be so Registered
 
Each Class is to be Registered
Common stock, par value $0.01 per share
  New York Stock Exchange
 
 
Securities to be registered pursuant to Section 12(g) of the Act:
None.
 
 
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company. See the definitions of “large accelerated filer,” “accelerated filer,” and “smaller reporting company” in Rule 12b-2 of the Securities Exchange Act of 1934, as amended. (Check one):
 
Large accelerated filer o Accelerated filer o Non-accelerated filer þ Smaller reporting company o
(Do not check if a smaller reporting company)
 


 

INFORMATION REQUIRED IN REGISTRATION STATEMENT
 
CROSS-REFERENCE SHEET BETWEEN INFORMATION STATEMENT AND ITEMS OF FORM 10
 
Item 1.   Business
 
The information required by this item is contained under the sections “Summary,” “Risk Factors,” “Special Note About Forward-Looking Statements,” “Unaudited Pro Forma Condensed Combined Financial Statements,” “Management’s Discussion and Analysis of Financial Condition and Results of Operations,” “Business,” “Management,” “Executive Compensation” and “Certain Relationships and Related Party Transactions” of the Information Statement filed as Exhibit 99.1 to this Registration Statement on Form 10 (the “Information Statement”). Those sections are incorporated herein by reference.
 
Item 1A.   Risk Factors
 
The information required by this item is contained under the section “Risk Factors” of the Information Statement. That section is incorporated herein by reference.
 
Item 2.   Financial Information
 
The information required by this item is contained under the sections “Summary — Summary Historical and Unaudited Pro Forma Condensed Combined Financial Data,” “Capitalization,” “Selected Historical Condensed Combined Financial and Other Data,” “Unaudited Pro Forma Condensed Combined Financial Statements” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations” of the Information Statement. Those sections are incorporated herein by reference.
 
Item 3.   Properties
 
The information required by this item is contained under the section “Business — Properties” of the Information Statement. That section is incorporated herein by reference.
 
Item 4.   Security Ownership of Certain Beneficial Owners and Management
 
The information required by this item is contained under the section “Security Ownership of Certain Beneficial Owners and Management” of the Information Statement. That section is incorporated herein by reference.
 
Item 5.   Directors and Executive Officers
 
The information required by this item is contained under the section “Management” of the Information Statement. That section is incorporated herein by reference.
 
Item 6.   Executive Compensation
 
The information required by this item is contained under the sections “Management” and “Executive Compensation” of the Information Statement. Those sections are incorporated herein by reference.
 
Item 7.   Certain Relationships and Related Transactions, and Director Independence
 
The information required by this item is contained under the sections “Management,” “Executive Compensation” and “Certain Relationships and Related Party Transactions” of the Information Statement. Those sections are incorporated herein by reference.
 
Item 8.   Legal Proceedings
 
The information required by this item is contained under the section “Business — Legal Proceedings” of the Information Statement. That section is incorporated herein by reference.


 

Item 9.   Market Price of and Dividends on the Registrant’s Common Equity and Related Stockholder Matters
 
The information required by this item is contained under the sections “Risk Factors,” “The Spin-Off,” “Dividend Policy,” “Executive Compensation” and “Description of Capital Stock” of the Information Statement. Those sections are incorporated herein by reference.
 
Item 10.   Recent Sales of Unregistered Securities
 
Not applicable.
 
Item 11.   Description of Registrant’s Securities to be Registered
 
The information required by this item is contained under the sections “Risk Factors — Risks Relating to Our Common Stock,” “Dividend Policy” and “Description of Capital Stock” of the Information Statement. Those sections are incorporated herein by reference.
 
Item 12.   Indemnification of Directors and Officers
 
The information required by this item is contained under the sections “Certain Relationships and Related Party Transactions — Agreements with ITT and Exelis Related to the Spin-Off — Distribution Agreement — Indemnification” and “Description of Capital Stock — Provisions of Our Amended and Restated Articles of Incorporation and Amended and Restated By-Laws That Could Delay or Prevent a Change in Control — Directors’ Duties and Liability” of the Information Statement. Those sections are incorporated herein by reference.
 
Item 13.   Financial Statements and Supplementary Data
 
The information required by this item is contained under the sections “Description of Capital Stock,” “Selected Historical Condensed Combined Financial and Other Data,” “Unaudited Pro Forma Condensed Combined Financial Statements,” “Management’s Discussion and Analysis of Financial Condition and Results of Operations,” and “Index to Financial Statements” and the statements referenced therein of the Information Statement. Those sections are incorporated herein by reference.
 
Item 14.   Changes in and Disagreements with Accountants on Accounting and Financial Disclosure
 
None.
 
Item 15.   Financial Statements and Exhibits
 
(a)   Financial Statements
 
The information required by this item is contained under the section “Index to Financial Statements” beginning on page F-1 of the Information Statement. That section is incorporated herein by reference.


 

(b)   Exhibits
 
The following documents are filed as exhibits hereto:
 
         
Exhibit No.
 
Description
 
  2 .1   Form of Distribution Agreement among ITT Corporation, Exelis Inc. and Xylem Inc.*
  3 .1   Form of Amended and Restated Articles of Incorporation of Xylem Inc.
  3 .2   Form of Amended and Restated By-Laws of Xylem Inc.
  4 .1   Form of Indenture between Xylem Inc. and Union Bank, National Association, as trustee.*
  10 .1   Form of Benefits and Compensation Matters Agreement among ITT Corporation, Exelis Inc. and Xylem Inc.*
  10 .2   Form of Tax Matters Agreement among ITT Corporation, Exelis Inc. and Xylem Inc.*
  10 .3   Form of Master Transition Services Agreement among ITT Corporation, Exelis Inc. and Xylem Inc.*
  10 .4   Forms of Master Lease Agreement and Master Sublease Agreement between ITT Corporation and Xylem Inc.*
  10 .5   Form of GOULDS Trademark License Agreement between Goulds Pumps Incorporated and Xylem Inc.*
  10 .6   Form of Xylem Inc. 2011 Omnibus Incentive Plan.*
  10 .7   Credit Agreement among Xylem Inc., the lenders party thereto, and J.P. Morgan Securities LLC and Citigroup Global Markets Inc., as lead arrangers and lead bookrunners.*
  21 .1   Subsidiaries of Xylem Inc.
  99 .1   Information Statement, dated September 13, 2011.
 
 
* To be filed by amendment.


 

SIGNATURES
 
Pursuant to the requirements of Section 12 of the Securities Exchange Act of 1934, the registrant has duly caused this registration statement to be signed on its behalf by the undersigned, thereunto duly authorized.
 
Xylem Inc.
 
  By: 
/s/  Gretchen W. McClain
Chief Executive Officer
 
Date: September 13, 2011