-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, I5S3XqCkzF65t3Brruyht5V3vyBgHdCEA4SZldiZATuIZvn39edRjQ5uFB35m0bA 1IxUa7SeNb63BMjVJydgAw== 0000950103-09-003333.txt : 20091221 0000950103-09-003333.hdr.sgml : 20091221 20091221144316 ACCESSION NUMBER: 0000950103-09-003333 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20091221 FILED AS OF DATE: 20091221 DATE AS OF CHANGE: 20091221 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hackedorn Lynne L. CENTRAL INDEX KEY: 0001477018 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34579 FILM NUMBER: 091252190 MAIL ADDRESS: STREET 1: C/O TWO POST OAK CENTRAL STREET 2: 1980 POST OAK BOULEVARD, SUITE 1200 CITY: HOUSTON STATE: TX ZIP: 77056 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Cobalt International Energy, Inc. CENTRAL INDEX KEY: 0001471261 STANDARD INDUSTRIAL CLASSIFICATION: CRUDE PETROLEUM & NATURAL GAS [1311] IRS NUMBER: 270821169 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: TWO POST OAK CENTRAL STREET 2: 1980 POST OAK BOULEVARD, SUITE 1200 CITY: HOUSTON STATE: TX ZIP: 77056 BUSINESS PHONE: (713) 579-9101 MAIL ADDRESS: STREET 1: TWO POST OAK CENTRAL STREET 2: 1980 POST OAK BOULEVARD, SUITE 1200 CITY: HOUSTON STATE: TX ZIP: 77056 4 1 dp15966_4-hackedornex.xml FORM 4 X0303 4 2009-12-21 0 0001471261 Cobalt International Energy, Inc. CIE 0001477018 Hackedorn Lynne L. C/O TWO POST OAK CENTRAL 1980 POST OAK BOULEVARD, SUITE 1200 HOUSTON TX 77056 0 1 0 0 Vice President, Land Common Stock 2009-12-21 4 J 0 167248 0 A 167248 D Common Stock 2009-12-21 4 A 0 179825 0 A 347073 D The reporting person received these shares of Common Stock as consideration for limited partnership interests in Cobalt International Energy, L.P. (the "Partnership") in connection with the reorganization of the Partnership, which involved the merger of the Partnership into a subsidiary of the Issuer, and the Issuer's initial public offering described in the prospectus dated December 15, 2009 (the "IPO"). 111,499 shares represent restricted shares granted under the Issuer's Long Term Incentive Plan (the "Plan") that will vest on April 1, 2010. 28,911 shares represent restricted shares granted under the Plan that will vest on December 21, 2014, subject to the terms of the award agreement under the Plan. 39,415 shares represent restricted shares granted under the Plan that will vest on December 21, 2014 but only if the average of the volume weighted average price of a share of the Issuer's Common Stock during the 90 day period ending on the day before December 21, 2014 equals or exceeds $13.50, subject to the terms of the award agreement under the Plan. /s/ Jeffrey A. Starzec, as Attorney-in-Fact 2009-12-21 -----END PRIVACY-ENHANCED MESSAGE-----