0001006655-17-000023.txt : 20170810 0001006655-17-000023.hdr.sgml : 20170810 20170810165259 ACCESSION NUMBER: 0001006655-17-000023 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170810 FILED AS OF DATE: 20170810 DATE AS OF CHANGE: 20170810 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Joe David CENTRAL INDEX KEY: 0001595999 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32942 FILM NUMBER: 171022068 MAIL ADDRESS: STREET 1: 2500 CITYWEST BLVD., SUITE 1300 CITY: HOUSTON STATE: TX ZIP: 77042 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 ROAD STREET 2: SUITE 425 CITY: HOUSTON STATE: TX ZIP: 77079 BUSINESS PHONE: 713-935-0122 MAIL ADDRESS: STREET 1: 1155 DAIRY ASHFORD ROAD 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 4 1 wf-form4_150239836592254.xml FORM 4 X0306 4 2017-08-10 0 0001006655 EVOLUTION PETROLEUM CORP EPM 0001595999 Joe David 1155 DAIRY ASHFORD, SUITE 425 HOUSTON TX 77079 0 1 0 0 SVP & CFO Common Stock 2017-08-10 4 M 0 1922 8.05 A 364484 D Common Stock 2017-08-10 4 F 0 789 8.05 D 363695 D Contingent Performance Stock Grant 0.0 2017-08-10 4 M 0 1922 8.05 D 2018-08-28 Common Stock 1922.0 0 D Contingent Restricted Stock award granted on August 28, 2014 that vested upon attainment of a specific performance goal. Shares surrendered to the Company to pay income tax withholding obligations. /s/ David Joe 2017-08-10