0001437749-23-020448.txt : 20230721 0001437749-23-020448.hdr.sgml : 20230721 20230721162457 ACCESSION NUMBER: 0001437749-23-020448 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230719 FILED AS OF DATE: 20230721 DATE AS OF CHANGE: 20230721 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hollis Michael L. CENTRAL INDEX KEY: 0001559864 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39464 FILM NUMBER: 231102776 MAIL ADDRESS: STREET 1: 500 WEST TEXAS STREET 2: SUITE 1225 CITY: MIDLAND STATE: TX ZIP: 79701 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HighPeak Energy, Inc. CENTRAL INDEX KEY: 0001792849 STANDARD INDUSTRIAL CLASSIFICATION: DRILLING OIL & GAS WELLS [1381] IRS NUMBER: 843533602 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 421 W. 3RD STREET STREET 2: SUITE 1000 CITY: FORT WORTH STATE: TX ZIP: 76102 BUSINESS PHONE: (817) 850-9200 MAIL ADDRESS: STREET 1: 421 W. 3RD STREET STREET 2: SUITE 1000 CITY: FORT WORTH STATE: TX ZIP: 76102 4 1 rdgdoc.xml FORM 4 X0508 4 2023-07-19 0001792849 HighPeak Energy, Inc. HPK 0001559864 Hollis Michael L. 421 W. 3RD STREET, SUITE 1000 FORT WORTH TX 76102 1 1 President 0 Common Stock, par value $0.0001 per share 2023-07-19 4 P 0 1142542 10.50 A 1467256 D Common Stock, par value $0.0001 per share 200 I By Sons Employee Stock Option (right to buy) 10.50 2023-07-21 4 A 0 400000 0 A 2026-10-31 Common Stock, par value $0.0001 per share 400000 400000 D Represents shares of HighPeak Energy, Inc. (the "Issuer") common stock, par value $0.0001 per share ("Common Stock") purchased by the Reporting Person from Roth Capital Partners, LLC (the "Underwriter") in an underwritten public offering conducted by the Issuer pursuant to an Underwriting Agreement between the Issuer and the Underwriter. The stock option was designed to comply with the requirements of Section 409A of the Internal Revenue Code of 1986, as amended, and the guidance thereunder, and is exercisable only during the 90 day period following the earlier to occur of the Reporting Person's separation from service due to death or disability, the occurrence of a change in control of the Issuer, or August 1, 2026. /s/ Steven W. Tholen as Attorney in Fact for Michael L. Hollis 2023-07-21