0001144204-16-113409.txt : 20160718 0001144204-16-113409.hdr.sgml : 20160718 20160718180817 ACCESSION NUMBER: 0001144204-16-113409 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160715 FILED AS OF DATE: 20160718 DATE AS OF CHANGE: 20160718 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Cypress Energy Partners, L.P. CENTRAL INDEX KEY: 0001587246 STANDARD INDUSTRIAL CLASSIFICATION: OIL, GAS FIELD SERVICES, NBC [1389] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 5727 S. LEWIS AVENUE, SUITE 500 CITY: TULSA STATE: OK ZIP: 74105 BUSINESS PHONE: 918-748-3900 MAIL ADDRESS: STREET 1: 5727 S. LEWIS AVENUE, SUITE 500 CITY: TULSA STATE: OK ZIP: 74105 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LABASS DON CENTRAL INDEX KEY: 0001596780 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36260 FILM NUMBER: 161772202 MAIL ADDRESS: STREET 1: C/O CYPRESS ENERGY PARTNERS, L.P. STREET 2: 5727 S. LEWIS AVENUE, SUITE 500 CITY: TULSA STATE: OK ZIP: 74105 4 1 v444433_4.xml OWNERSHIP DOCUMENT X0306 4 2016-07-15 0 0001587246 Cypress Energy Partners, L.P. CELP 0001596780 LABASS DON C/O CYPRESS ENERGY PARTNERS, L.P. 5727 S. LEWIS AVENUE, SUITE 300 TULSA OK 74105 0 1 0 0 SEE REMARKS Common Units (Limited Partner Interests) 2016-07-15 4 M 0 1700 A 1700 D Common Units (Limited Partner Interests) 2016-07-15 4 F 0 535 10.34 D 1165 D Common Units (Limited Partner Interests) 2016-07-15 4 D 0 1165 10.34 D 0 D Phantom Units (Limited Partner Interests) 2016-07-15 4 M 0 1700 D Common Units (Limited Partner Interests) 1700 3400 D Each phantom unit is the economic equivalent of one common unit. On January 21, 2014, the Reporting Person was granted 5,100 phantom units which vest in three equal installments on each of July 15, 2016, 2017 and 2018. The phantom units expire upon settlement. The phantom units are settled upon vesting in common units (on a one-for-one basis) or in cash, at the discretion of the Issuer. The Reporting Person is Vice President, Controller and Chief Accounting Officer of Cypress Energy Partners GP, LLC, the general partner of the Issuer (the "General Partner"). The Issuer is managed by the directors and executive officers of the General Partner. /s/ Richard M. Carson, Attorney-in-Fact for Don LaBass 2016-07-18