0001413507-17-000058.txt : 20170403
0001413507-17-000058.hdr.sgml : 20170403
20170403180214
ACCESSION NUMBER: 0001413507-17-000058
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170330
FILED AS OF DATE: 20170403
DATE AS OF CHANGE: 20170403
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: SRC Energy Inc.
CENTRAL INDEX KEY: 0001413507
STANDARD INDUSTRIAL CLASSIFICATION: CRUDE PETROLEUM & NATURAL GAS [1311]
IRS NUMBER: 202835920
STATE OF INCORPORATION: CO
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1675 BROADWAY
STREET 2: SUITE 2600
CITY: DENVER
STATE: CO
ZIP: 80202
BUSINESS PHONE: 720-616-4300
MAIL ADDRESS:
STREET 1: 1675 BROADWAY
STREET 2: SUITE 2600
CITY: DENVER
STATE: CO
ZIP: 80202
FORMER COMPANY:
FORMER CONFORMED NAME: SYNERGY RESOURCES Corp
DATE OF NAME CHANGE: 20160415
FORMER COMPANY:
FORMER CONFORMED NAME: SYNERGY RESOURCES CORP
DATE OF NAME CHANGE: 20081104
FORMER COMPANY:
FORMER CONFORMED NAME: Brishlin Resources, Inc.
DATE OF NAME CHANGE: 20071217
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Osborn Cathleen M
CENTRAL INDEX KEY: 0001675611
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35245
FILM NUMBER: 17735635
MAIL ADDRESS:
STREET 1: 1625 BROADWAY
STREET 2: SUITE 300
CITY: DENVER
STATE: CO
ZIP: 80202
4
1
wf-form4_149125691977802.xml
FORM 4
X0306
4
2017-03-30
0
0001413507
SRC Energy Inc.
SRCI
0001675611
Osborn Cathleen M
1675 BROADWAY
SUITE 2600
DENVER
CO
80202
0
1
0
0
Vice President/General Counsel
Common Stock
2017-03-30
4
F
0
3251
8.37
D
91021
D
To satisfy tax withholding obligation related to vesting of restricted stock units.
/s/ Cathleen M. Osborn
2017-04-03