0001104659-22-077594.txt : 20220706 0001104659-22-077594.hdr.sgml : 20220706 20220706110223 ACCESSION NUMBER: 0001104659-22-077594 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210802 FILED AS OF DATE: 20220706 DATE AS OF CHANGE: 20220706 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Schultz Roderick A. CENTRAL INDEX KEY: 0001872155 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-32942 FILM NUMBER: 221067779 MAIL ADDRESS: STREET 1: 4621 PINERIDGE STREET CITY: HOUSTON STATE: TX ZIP: 77009 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/A 1 tm2220479-1_4aseq1.xml OWNERSHIP DOCUMENT X0306 4/A 2021-08-02 2021-08-04 1 0001006655 EVOLUTION PETROLEUM CORP EPM 0001872155 Schultz Roderick A. 4621 PINERIDGE STREET HOUSTON TX 77009 0 1 0 0 Chief Accounting Officer Common Stock 2021-08-02 4 D 0 71045 0.00 D 51533 D Contingent Performance Stock Grant 0 2021-08-02 4 D 0 19361 0 D 2024-12-09 Common Stock 19361 0 D Forfeiture of unvested awards upon the August 2, 2021 retirement of the reporting person under the terms of a Separation Agreement. Award of contingent restricted stock is subject to the grant agreement's vesting conditions. /s/ Roderick A. Schultz 2022-07-06