0001756030-21-000002.txt : 20211005 0001756030-21-000002.hdr.sgml : 20211005 20211005165145 ACCESSION NUMBER: 0001756030-21-000002 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211001 FILED AS OF DATE: 20211005 DATE AS OF CHANGE: 20211005 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Riley Bobby CENTRAL INDEX KEY: 0001756030 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-15555 FILM NUMBER: 211307428 MAIL ADDRESS: STREET 1: 29 EAST RENO STREET 2: SUITE 500 CITY: OKLAHOMA CITY STATE: OK ZIP: 73104 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Riley Exploration Permian, Inc. CENTRAL INDEX KEY: 0001001614 STANDARD INDUSTRIAL CLASSIFICATION: CRUDE PETROLEUM & NATURAL GAS [1311] IRS NUMBER: 870267438 STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 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 wf-form4_163346708587269.xml FORM 4 X0306 4 2021-10-01 0 0001001614 Riley Exploration Permian, Inc. REPX 0001756030 Riley Bobby C/O RILEY EXPLORATION PERMIAN, INC. 29 EAST RENO, SUITE 500 OKLAHOMA CITY OK 73104 1 1 0 0 CHIEF EXECUTIVE OFFICER Common Stock, par value $0.001 per share 2021-10-01 4 A 0 38309 0 A 320482 D Common Stock, par value $0.001 per share 2021-10-01 4 F 0 4257 23.48 D 316225 D These shares are restricted stock acquired under Issuer's Riley Exploration Permian, Inc. 2021 Long Term Incentive Plan on October 1, 2021. Subject to certain contingencies and provisions allowing for accelerated vesting in certain instances, the shares of restricted stock vest in equal amounts on October 1, 2022, October 1, 2023, and October 1, 2024. This amount includes 106,529 shares of restricted common stock subject to vesting and certain other restrictions. These shares were surrendered to satisfy the withholding tax liability incurred upon the vesting of shares of restricted stock originally issued to the reporting person as a substitute equity award pursuant to the Riley Exploration Permian, Inc. 2021 Long Term Incentive Plan which converted a previously-issued equity grant at the closing of the Company's merger on February 26, 2021 and does not represent a discretionary trade by the reporting person. Bobby D. Riley 2021-10-05