0001127602-19-004044.txt : 20190205 0001127602-19-004044.hdr.sgml : 20190205 20190205155957 ACCESSION NUMBER: 0001127602-19-004044 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190201 FILED AS OF DATE: 20190205 DATE AS OF CHANGE: 20190205 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Humber Christopher CENTRAL INDEX KEY: 0001537197 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37995 FILM NUMBER: 19567828 MAIL ADDRESS: STREET 1: 410 17TH STREET STREET 2: SUITE 1400 CITY: DENVER STATE: CO ZIP: 80202 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Jagged Peak Energy Inc. CENTRAL INDEX KEY: 0001685715 STANDARD INDUSTRIAL CLASSIFICATION: CRUDE PETROLEUM & NATURAL GAS [1311] IRS NUMBER: 813943703 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1401 LAWRENCE STREET, SUITE 1800 CITY: DENVER STATE: CO ZIP: 80202 BUSINESS PHONE: (720) 215-3700 MAIL ADDRESS: STREET 1: 1401 LAWRENCE STREET, SUITE 1800 CITY: DENVER STATE: CO ZIP: 80202 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2019-02-01 0001685715 Jagged Peak Energy Inc. JAG 0001537197 Humber Christopher 1401 LAWRENCE STREET, SUITE 1800 DENVER CO 80202 1 EVP, GC & Secretary Common Stock 2019-02-01 4 A 0 40575 10.53 A 125126 D Common Stock 2019-02-01 4 F 0 12144 10.53 D 112982 D Represents shares of Jagged Peak Energy Inc. (the "Company") common stock received in connection with the vesting of Series B Units of JPE Management Holdings LLC. Represents shares of Company common stock withheld by the Company to satisfy the tax obligations of the Reporting Person upon the vesting of Series B Units of JPE Management Holdings LLC. /s/ Christopher I. Humber 2019-02-05