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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
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 Underlying Securities (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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Restricted Stock Unit | (2) | 03/05/2012 | M(1) | 4,230 | (5) | (5) | Common Stock | 4,230 | $ 0 | 3,959 | D | ||||
Employee Stock Option (Right to Buy) | $ 27.49 | 03/01/2013 | A | 32,013 | (6) | 03/01/2023 | Common Stock | 32,013 | $ 0 | 32,013 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Kuchenbrod Michael 1133 WESTCHESTER AVENUE C/O XYLEM INC. WHITE PLAINS, NY 10604 |
Senior Vice President |
/s/ Rina E. Teran, Assistant Corporate Secretary of Xylem Inc., by power of attorney for Michael Kuchenbrod | 03/05/2013 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | Reflects the cash-settlement of restricted stock units granted on March 5, 2009 under the ITT Corp 2003 Equity Incentive Plan. Equity awards previously granted by ITT Corporation were converted into restricted stock units of Xylem Inc. in connection with the spin-off of Xylem Inc. from ITT Corporation on October 31, 2011. |
(2) | Each restricted stock unit ("RSU") represents the right to receive the cash value of one share of Xylem Inc. common stock. |
(3) | Reflects an award of restricted stock units which are scheduled to vest on March 1, 2016. |
(4) | As of December 31, 2012. |
(5) | 4,230 RSUs vested on March 5, 2012 and 3,959 vested on March 5, 2013. |
(6) | These options vest in three equal annual installments beginning on March 1, 2014. |