0001006655-17-000051.txt : 20171108 0001006655-17-000051.hdr.sgml : 20171108 20171108184406 ACCESSION NUMBER: 0001006655-17-000051 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171106 FILED AS OF DATE: 20171108 DATE AS OF CHANGE: 20171108 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: 171187842 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_151018463268659.xml FORM 4 X0306 4 2017-11-06 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 2017-11-06 4 M 0 12931 7.20 A 264220 D Common Stock 2017-11-06 4 F 0 16275 7.20 D 247945 D Common Stock 2017-11-06 4 A 0 26125 0 A 274070 D Contingent Performance Stock Grant 0.0 2017-11-06 4 M 0 12931 7.20 D 2019-12-04 Common Stock 12931.0 0 D Contingent Restricted Stock award granted on December 4, 2015 that vested upon attainment of a specific performance goal. Shares surrendered to the Company to pay income tax withholding obligations. Award of Restricted Stock pursuant to Company's 2016 Equity Incentive Plan, subject to vesting. /s/ Randall D. Keys 2017-11-08