0001847420-21-000002.txt : 20210930 0001847420-21-000002.hdr.sgml : 20210930 20210930105501 ACCESSION NUMBER: 0001847420-21-000002 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210928 FILED AS OF DATE: 20210930 DATE AS OF CHANGE: 20210930 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Palmer Michael H CENTRAL INDEX KEY: 0001847420 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-15555 FILM NUMBER: 211294117 MAIL ADDRESS: STREET 1: 912 CORBETT DR CITY: NORMAN STATE: OK ZIP: 73072 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_163301368861502.xml FORM 4 X0306 4 2021-09-28 0 0001001614 Riley Exploration Permian, Inc. REPX 0001847420 Palmer Michael H C/O RILEY EXPLORATION PERMIAN, INC. 29 EAST RENO, SUITE 500 OKLAHOMA CITY OK 73104 0 1 0 0 EVP CORPORATE LAND Common Stock, par value $0.001 per share 2021-09-28 4 F 0 560 24.35 D 19832 D 1.These shares were surrendered to satisfy the withholding tax liability incurred upon the vesting of certain securities originally granted to the reporting person pursuant to the 2018 Riley Exploration Permian, LLC Long Term Incentive Plan and does not represent a discretionary trade by the reporting person. This amount includes 16,978 shares of restricted common stock acquired under the 2021 Riley Exploration Permian, Inc. Long Term Incentive Plan that remain subject to vesting and other restrictions. /s/Michael Palmer 2021-09-29