0001354488-16-008477.txt : 20161107 0001354488-16-008477.hdr.sgml : 20161107 20161107160554 ACCESSION NUMBER: 0001354488-16-008477 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161026 FILED AS OF DATE: 20161107 DATE AS OF CHANGE: 20161107 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Yuma Energy, Inc. CENTRAL INDEX KEY: 0001672326 STANDARD INDUSTRIAL CLASSIFICATION: CRUDE PETROLEUM & NATURAL GAS [1311] IRS NUMBER: 812235304 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1177 WEST LOOP SOUTH STREET 2: SUITE 1825 CITY: HOUSTON STATE: TX ZIP: 77027 BUSINESS PHONE: 713-968-7000 MAIL ADDRESS: STREET 1: 1177 WEST LOOP SOUTH STREET 2: SUITE 1825 CITY: HOUSTON STATE: TX ZIP: 77027 FORMER COMPANY: FORMER CONFORMED NAME: Yuma Delaware Merger Subsidiary, Inc. DATE OF NAME CHANGE: 20160415 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jacobs James J CENTRAL INDEX KEY: 0001368353 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37932 FILM NUMBER: 161978122 MAIL ADDRESS: STREET 1: 801 TRAVIS STREET 2: SUITE 2020 CITY: HOUSTON STATE: TX ZIP: 77002 3 1 issuerdirect_section16.xml PRIMARY DOCUMENT X0206 3 2016-10-26 0 0001672326 Yuma Energy, Inc. YUMA 0001368353 Jacobs James J 1177 WEST LOOP SOUTH, SUITE 1825 HOUSTON TX 77027 1 Chief Financial Officer Common Stock 28570 D Stock Appreciation Rights 12.1 2018-08-22 Common Stock 13416 D Reflects the undersigned?s beneficial ownership of shares of common stock of the Issuer after the reincorporation of Yuma Energy, Inc., a California corporation, to Delaware and the 1-for-20 reverse stock split. Includes shares from restricted stock awards after accounting for the reincorporation and the 1-for-20 reverse stock split that vest as to 707 shares on January 1, 2017, 5,461 shares on May 31, 2017, and 5,461 shares on May 31, 2018. The stock appreciation right award reflects the reincorporation and the 1-for-20 reverse stock split, and vested as to 4,472 SARs on May 31, 2016, and vests as to 4,472 SARs on May 31, 2017, and as to 4,472 SARs on May 31, 2018. Reflects accounting for reincorporation and 1-for-20 reverse stock split. /s/ James J. Jacobs 2016-11-07