0001632977-24-000009.txt : 20240604 0001632977-24-000009.hdr.sgml : 20240604 20240604162754 ACCESSION NUMBER: 0001632977-24-000009 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240601 FILED AS OF DATE: 20240604 DATE AS OF CHANGE: 20240604 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Bonney Amber CENTRAL INDEX KEY: 0001632977 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-15555 FILM NUMBER: 241018520 MAIL ADDRESS: STREET 1: 914 N. BROADWAY, SUITE 230 CITY: OKLAHOMA CITY STATE: OK ZIP: 73102 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Riley Exploration Permian, Inc. CENTRAL INDEX KEY: 0001001614 STANDARD INDUSTRIAL CLASSIFICATION: CRUDE PETROLEUM & NATURAL GAS [1311] ORGANIZATION NAME: 01 Energy & Transportation IRS NUMBER: 870267438 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 29 E. RENO AVENUE STREET 2: SUITE 500 CITY: OKLAHOMA CITY STATE: OK ZIP: 73104 BUSINESS PHONE: 405-415-8699 MAIL ADDRESS: STREET 1: 29 E. RENO AVENUE STREET 2: SUITE 500 CITY: OKLAHOMA CITY STATE: OK ZIP: 73104 FORMER COMPANY: FORMER CONFORMED NAME: TENGASCO INC DATE OF NAME CHANGE: 19960612 4 1 wk-form4_1717532864.xml FORM 4 X0508 4 2024-06-01 1 0001001614 Riley Exploration Permian, Inc. REPX 0001632977 Bonney Amber C/O RILEY EXPLORATION PERMIAN, INC. 29 E. RENO, SUITE 500 OKLAHOMA CITY OK 73104 0 1 0 0 Chief Accounting Officer 0 Common Stock 2024-06-01 4 D 0 16448 0 D 75626 D These shares were forfeited to the Issuer pursuant to that certain Separation and Release Agreement by and between the Filer and the Issuer dated June 1, 2024. This amount includes 61,773 shares of restricted common stock subject to vesting and certain other restrictions. /s/ Amber Bonney 2024-06-04