0001006655-16-000165.txt : 20161212
0001006655-16-000165.hdr.sgml : 20161212
20161212161622
ACCESSION NUMBER: 0001006655-16-000165
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20161208
FILED AS OF DATE: 20161212
DATE AS OF CHANGE: 20161212
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: EVOLUTION PETROLEUM CORP
CENTRAL INDEX KEY: 0001006655
STANDARD INDUSTRIAL CLASSIFICATION: CRUDE PETROLEUM & NATURAL GAS [1311]
IRS NUMBER: 411781991
STATE OF INCORPORATION: NV
FISCAL YEAR END: 0630
BUSINESS ADDRESS:
STREET 1: 1155 DAIRY ASHFORD ST.
STREET 2: SUITE 425
CITY: HOUSTON
STATE: TX
ZIP: 77079
BUSINESS PHONE: 713-935-0122
MAIL ADDRESS:
STREET 1: 1155 DAIRY ASHFORD ST.
STREET 2: SUITE 425
CITY: HOUSTON
STATE: TX
ZIP: 77079
FORMER COMPANY:
FORMER CONFORMED NAME: NATURAL GAS SYSTEMS INC/NEW
DATE OF NAME CHANGE: 20040817
FORMER COMPANY:
FORMER CONFORMED NAME: NATURAL GAS SYSTEMS, INC.
DATE OF NAME CHANGE: 20040810
FORMER COMPANY:
FORMER CONFORMED NAME: REALITY INTERACTIVE INC
DATE OF NAME CHANGE: 19960301
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Dozier William
CENTRAL INDEX KEY: 0001350032
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-32942
FILM NUMBER: 162046452
MAIL ADDRESS:
STREET 1: 3000 SAGE #1312
CITY: HOUSTON
STATE: TX
ZIP: 77056
4
1
wf-form4_148157737002039.xml
FORM 4
X0306
4
2016-12-08
0
0001006655
EVOLUTION PETROLEUM CORP
EPM
0001350032
Dozier William
1155 DAIRY ASHFORD, SUITE 425
HOUSTON
TX
77079
1
0
0
0
Common Stock
2016-12-08
4
A
0
6418
9.35
A
132461
D
Award of Restricted Stock pursuant to Company's 2004 Amended and Restated Stock Plan, as amended, subject to vesting.
/s/ William Dozier
2016-12-12