0001357400-18-000197.txt : 20181226 0001357400-18-000197.hdr.sgml : 20181226 20181226170611 ACCESSION NUMBER: 0001357400-18-000197 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20181221 FILED AS OF DATE: 20181226 DATE AS OF CHANGE: 20181226 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Purgason Robert S CENTRAL INDEX KEY: 0001308543 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38048 FILM NUMBER: 181253131 MAIL ADDRESS: STREET 1: 2818 S. VICTOR AVENUE CITY: TULSA STATE: OK ZIP: 74114 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Altus Midstream Co CENTRAL INDEX KEY: 0001692787 STANDARD INDUSTRIAL CLASSIFICATION: CRUDE PETROLEUM & NATURAL GAS [1311] IRS NUMBER: 814675947 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2000 POST OAK BOULEVARD STREET 2: SUITE 100 CITY: HOUSTON STATE: TX ZIP: 77056-4400 BUSINESS PHONE: 713-296-6000 MAIL ADDRESS: STREET 1: 2000 POST OAK BOULEVARD STREET 2: SUITE 100 CITY: HOUSTON STATE: TX ZIP: 77056-4400 FORMER COMPANY: FORMER CONFORMED NAME: Kayne Anderson Acquisition Corp DATE OF NAME CHANGE: 20161220 4 1 f4forprs.xml PRIMARY DOCUMENT X0306 4 2018-12-21 0 0001692787 Altus Midstream Co ALTM 0001308543 Purgason Robert S 2000 POST OAK BLVD, STE 100 HOUSTON TX 77056 1 0 0 0 Director Common Stock 2018-12-21 4 J 0 418904. 0 A 418904. D Common Stock 2018-12-21 4 J 0 100000. 0 A 518904. D Warrents (right to buy) 11.50 2018-12-21 4 J 0 497210. 0 A 2018-12-09 2023-11-09 Class A Common Stock 497210. 497210. D Pro rata distribution from Kayne Anderson Sponsor, LLC to its members. Pro rata distribution from Kayne Anderson SPAC, LLC to its members. Note: Also see attached Exhibit EX-24 Purgason POA. Raj Sharma, Attorney-in-Fact 2018-12-26 EX-24 2 robertspurgasonpoa19dec2018.txt PURGASON POA Power of Attorney (Limited to Execution of Forms 4 and 5) I, Robert S. Purgason, do hereby constitute and appoint Rajesh Sharma and Patrick Whitman (with full power to each of them to act alone) as my true and lawful agents and attorneys-in-fact with full power and authority to execute and deliver on my behalf in accordance with Securities and Exchan Commission rules and regulations all reports of changes in my beneficial ownership of securities issued by Altus Midstream Company on Forms 4 and 5 as may be deemed advisable. I hereby ratify and confirm all that each such agent and attorney-in-fact may do by virtue hereof with respect to reports of my beneficial ownership of securities issued by Altus Midstream Company. This power of attorney shall remain in full force and effect until I am no longer required to file Forms 4 and 5 with respect to changes in my beneficial ownership of securities issued by Altus Midstream Company, unless earlier revoked by me in writing delivered to the attorneys-in-fact named above. In witness whereof, I have duly executed this power of attorney on the 21st day of December 2018. /s/ Robert S. Purgason State of Texas County of Harris On this 21st day of December 2018, before me personally came Robert S. Purgason, to me known, and acknowledged this instrument. Witness my hand and official seal. /s/ Melinda Jenkins [Seal for Melinda Jenkins] [Notary Public, State of Texas] [My Commission Expires 07-25-2020]