0001209191-16-143288.txt : 20160930 0001209191-16-143288.hdr.sgml : 20160930 20160930160803 ACCESSION NUMBER: 0001209191-16-143288 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160930 FILED AS OF DATE: 20160930 DATE AS OF CHANGE: 20160930 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: SemGroup Corp CENTRAL INDEX KEY: 0001489136 STANDARD INDUSTRIAL CLASSIFICATION: OIL, GAS FIELD SERVICES, NBC [1389] IRS NUMBER: 203533152 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: TWO WARREN PLACE STREET 2: 6120 SOUTH YALE AVENUE, SUITE 700 CITY: TULSA STATE: OK ZIP: 74136-4216 BUSINESS PHONE: 918-524-8100 MAIL ADDRESS: STREET 1: TWO WARREN PLACE STREET 2: 6120 SOUTH YALE AVENUE, SUITE 700 CITY: TULSA STATE: OK ZIP: 74136-4216 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BALLSCHMIEDE RONALD A CENTRAL INDEX KEY: 0001366918 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34736 FILM NUMBER: 161912969 MAIL ADDRESS: STREET 1: 2103 RESEARCH FOREST DRIVE CITY: THE WOODLANDS STATE: TX ZIP: 77380 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2016-09-30 0 0001489136 SemGroup Corp SEMG 0001366918 BALLSCHMIEDE RONALD A 6120 SOUTH YALE AVE. SUITE 700 TULSA OK 74136 1 0 0 0 Common Stock 2016-09-30 4 A 0 3937 0.00 A 8912 D Common Stock 15358 I Held by GRAT On September 30, 2016, pursuant to an Agreement and Plan of Merger entered into by Rose Rock Midstream, L.P. ("RRMS"), Rose Rock Midstream GP, LLC, SemGroup Corporation ("SemGroup"), and PBMS, LLC, each outstanding common unit representing limited partner interests in RRMS (each a "Common Unit") held by the Reporting Person converted into 0.8136 shares of validly issued, fully paid and non-assessable SemGroup Class A common stock, par value $0.01 per share (the "Merger Exchange"). As a result of the Merger Exchange, SemGroup issued the common stock reported on Table 1 to the Reporting Person. 15,358 shares previously reports as directly owned are now being reports as indirectly owned by the RAB GRAT 2016-1 grantor annuity trust ("GRAT"). The reporting person is the sole trustee and sole annuitant of the GRAT. Candice L. Cheeseman, Power of Attorney for Ronald A. Ballschmiede 2016-09-30