0001006655-17-000028.txt : 20170906
0001006655-17-000028.hdr.sgml : 20170906
20170906171400
ACCESSION NUMBER: 0001006655-17-000028
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170901
FILED AS OF DATE: 20170906
DATE AS OF CHANGE: 20170906
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Keys Randall D
CENTRAL INDEX KEY: 0001050736
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-32942
FILM NUMBER: 171072074
MAIL ADDRESS:
STREET 1: 3 HICKORY SHADOWS DR
CITY: HOUSTON
STATE: TX
ZIP: 77055
FORMER NAME:
FORMER CONFORMED NAME: KEYS RANDALL D
DATE OF NAME CHANGE: 19971203
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_150473242722702.xml
FORM 4
X0306
4
2017-09-01
0
0001006655
EVOLUTION PETROLEUM CORP
EPM
0001050736
Keys Randall D
1155 DAIRY ASHFORD, SUITE 425
HOUSTON
TX
77079
0
1
0
0
President and CEO
Common Stock
2017-09-01
4
F
0
6189
6.95
D
251899
D
Shares surrendered to the Company to pay income tax withholding obligations.
/s/ Randall D. Keys
2017-09-06