UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 15
CERTIFICATION AND NOTICE OF TERMINATION OF REGISTRATION
UNDER SECTION 12(g) OF THE SECURITIES EXCHANGE ACT OF 1934
OR SUSPENSION OF DUTY TO FILE REPORTS UNDER SECTIONS 13 AND 15(d)
OF THE SECURITIES EXCHANGE ACT OF 1934
Commission File Number
001-32498
333-214924
XERIUM TECHNOLOGIES, INC.
(Exact name of registrant as specified in its charter)
Xerium
Technologies, Inc.
14101 Capital Boulevard
Youngsville, North Carolina 27596
(919)
526-1414
(Address, including zip code, and telephone number, including area code, of registrant’s principal executive offices)
Copy to:
Kilpatrick Townsend & Stockton, LLP
1100 Peachtree Street, Suite 2800
Atlanta, Georgia 30309-4528
Attn: W. Benjamin Barkley
Common Stock, par value $0.001
Preferred Stock Purchase Rights
9.500% Senior Secured Notes due 2021
(Title of each class of securities covered by this Form)
None
(Titles of all
other classes of securities for which a duty to file reports under Section 13(a) or 15(d) remains)
Please place an
X in the box(es) to designate the appropriate rule provisions(s) relied upon to terminate or suspend the duty to file reports:
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Rule
12g-4(a)(1)
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☒
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Rule
12g-4(a)(2)
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☐
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Rule
12h-3(b)(1)(i)
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☒
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Rule
12h-3(b)(1)(ii)
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☐
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Rule
15d-6
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☐
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Rule
15d-22(b)
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☐
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Approximate number of holders of record as of the certification or notice date:
Common Stock, par value $0.001: 1
Preferred Stock Purchase Rights: 0
9.500% Senior Secured Notes due 2021: 0
Pursuant to the requirements of the Securities Exchange Act of 1934, Xerium Technologies, Inc. has caused this certification/notice to be
signed on its behalf by the undersigned duly authorized person.
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XERIUM TECHNOLOGIES, INC.
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Date: November 2, 2018
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By
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/s/ Phillip B. Kennedy
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Name:
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Phillip B. Kennedy
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Title:
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Executive Vice President, General Counsel & Secretary
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