SEC Form 5
FORM 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

ANNUAL 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).
  
Form 3 Holdings Reported.
  
Form 4 Transactions Reported.
1. Name and Address of Reporting Person*
Bryant Joseph H

(Last) (First) (Middle)
COBALT CENTER
920 MEMORIAL CITY WAY, SUITE 100

(Street)
HOUSTON TX 77024

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Cobalt International Energy, Inc. [ CIE ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
Chair. of the Board Dir. & CEO
3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year)
12/31/2012
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
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 at end of Issuer's Fiscal Year (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Amount (A) or (D) Price
Common Stock 12/08/2011 W 41 A $0 4,162,462 D
Common Stock 12/18/2012 G(1) 625,000 D $0 3,537,462 D
Common Stock 12/18/2012 G(2) 263,300 D $0 3,274,162 D
Common Stock 12/18/2012 G(3) 506,152 D $0 0 I See footnote(3)
Common Stock 12/18/2012 G(4) 1,131,152 A $0 1,131,152 I See footnote(4)
Common Stock 12/31/2012 G(5) 652,589 D $0 1,131,152 I See footnote(5)
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)
(A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Explanation of Responses:
1. The reporting person transferred these shares to a limited partnership (the "Limited Partnership"). The reporting person and his spouse are 100% owners of the sole general partner of the Limited Partnership.
2. The reporting person transferred these shares by gift to a charitable foundation.
3. These shares were transferred to the Limited Partnership by certain trusts for the benefit of the reporting person's children. The reporting person disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein.
4. These shares were transferred to the Limited Partnership by the reporting person (625,000 shares) and by certain trusts for the benefit of the reporting person's children (506,152 shares). The reporting person disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein.
5. Represents a gift of limited partnership interests in the Limited Partnership by the reporting person to certain trusts for the benefit of the reporting person's children. The gift represents a 57.6924% interest in the Limited Partnership. The reporting person disclaims beneficial ownership of the shares held by the Limited Partnership except to the extent of his pecuniary interest therein.
Remarks:
/s/ Jeffrey A. Starzec, Attorney-in-Fact 02/14/2013
** 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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 Number.