FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 01/18/2018 |
3. Issuer Name and Ticker or Trading Symbol
Nine Energy Service, Inc. [ NINE ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock | 1,132,238 | I | See Footnote(1) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Explanation of Responses: |
1. Represents 938,063 shares of common stock, $0.01 par value per share ("Common Stock"), of Nine Energy Service, Inc. directly owned by SCF-VII, L.P. and 194,175 shares of Common Stock directly owned by SCF-VII(A), L.P. L.E. Simmons & Associates, Incorporated ("LESA") is the sole general partner of each of (a) SCF-VII, G.P., Limited Partnership, which is the sole general partner of SCF-VII, L.P., and (b) SCF-VII(A), G.P., Limited Partnership, which is the sole general partner of SCF-VII(A), L.P. Mr. Baldwin serves as Co-President of LESA. As such, Mr. Baldwin may be deemed to have dispositive power over the shares of Common Stock directly owned by SCF-VII, L.P. and SCF-VII(A), L.P. Mr. Baldwin disclaims beneficial ownership of such shares. |
Remarks: |
This Form 3 is being filed in connection with the effectiveness of the Registration Statement on Form S-1 (Registration No. 333- 217601) of Nine Energy Service, Inc. See attached for Exhibit 24 - Power of Attorney. |
/s/ David C. Baldwin by Theodore R. Moore, as Attorney-in-fact | 01/18/2018 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |