0001104659-19-005096.txt : 20190201 0001104659-19-005096.hdr.sgml : 20190201 20190201161553 ACCESSION NUMBER: 0001104659-19-005096 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190201 FILED AS OF DATE: 20190201 DATE AS OF CHANGE: 20190201 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Boaz Energy II, LLC CENTRAL INDEX KEY: 0001719890 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38472 FILM NUMBER: 19560018 BUSINESS ADDRESS: STREET 1: 3300 N. A STREET BLDG. 7 #150 CITY: MIDLAND STATE: TX ZIP: 79705 BUSINESS PHONE: (432) 253-7074 MAIL ADDRESS: STREET 1: 3300 N. A STREET BLDG. 7 #150 CITY: MIDLAND STATE: TX ZIP: 79705 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: NGP X US Holdings LP CENTRAL INDEX KEY: 0001606887 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38472 FILM NUMBER: 19560019 BUSINESS ADDRESS: STREET 1: 5221 N. O'CONNOR BOULEVARD STREET 2: SUITE 1100 CITY: IRVING STATE: TX ZIP: 75039 BUSINESS PHONE: 972-432-1440 MAIL ADDRESS: STREET 1: 5221 N. O'CONNOR BOULEVARD STREET 2: SUITE 1100 CITY: IRVING STATE: TX ZIP: 75039 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: NGP Boaz Energy II Co-Invest LLC CENTRAL INDEX KEY: 0001739246 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38472 FILM NUMBER: 19560020 BUSINESS ADDRESS: STREET 1: 5221 N. O'CONNOR BOULEVARD STREET 2: SUITE 1100 CITY: IRVING STATE: TX ZIP: 75039 BUSINESS PHONE: (972) 432-1440 MAIL ADDRESS: STREET 1: 5221 N. O'CONNOR BOULEVARD STREET 2: SUITE 1100 CITY: IRVING STATE: TX ZIP: 75039 FORMER NAME: FORMER CONFORMED NAME: NGP Boaz II Co-Invest LLC DATE OF NAME CHANGE: 20180501 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PermRock Royalty Trust CENTRAL INDEX KEY: 0001724009 STANDARD INDUSTRIAL CLASSIFICATION: CRUDE PETROLEUM & NATURAL GAS [1311] IRS NUMBER: 826725102 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: P.O. BOX 470727 STREET 2: ATTN: LEE ANN ANDERSON CITY: FORT WORTH STATE: TX ZIP: 76147 BUSINESS PHONE: (855) 588-7839 MAIL ADDRESS: STREET 1: P.O. BOX 470727 STREET 2: ATTN: LEE ANN ANDERSON CITY: FORT WORTH STATE: TX ZIP: 76147 4 1 a4.xml 4 X0306 4 2019-02-01 0 0001724009 PermRock Royalty Trust PRT 0001719890 Boaz Energy II, LLC 3300 N. A STREET BLDG. 7 #150 MIDLAND TX 79705 0 0 1 0 0001606887 NGP X US Holdings LP 5221 N. O'CONNOR BOULEVARD SUITE 1100 IRVING TX 75039 0 0 1 0 0001739246 NGP Boaz Energy II Co-Invest LLC 5221 N. O'CONNOR BOULEVARD SUITE 1100 IRVING TX 75039 0 0 1 0 Trust Units representing Beneficial Interests 2019-02-01 4 J 0 37400 D 5878332 D On February 1, 2019, Boaz Energy II, LLC, a Delaware limited liability company ("Boaz Energy") granted Trust Units representing beneficial interests in the Issuer ("Trust Units") to certain employees of Boaz Energy pursuant to individual Trust Unit Agreements entered into between Boaz Energy and such employees. No consideration was paid to Boaz Energy in respect of such grants. Boaz Energy directly owns the Trust Units. All other reporting persons' ownership is indirect through Boaz Energy. /s/ Boaz Energy II, LLC By: Marshall Eves, Chief Executive Officer 2019-02-01 /s/ NGP X US Holdings, L.P. By:NGP X Holdings GP, L.L.C., its general partner By: Tony R. Weber, Authorized Person 2019-02-01 /s/ NGP Boaz Energy II Co-Invest LLC By: G.F.W. Energy X, L.P., its managing member By: GFW X, L.L.C., its general partner By: Tony R. Weber, Authorized Person 2019-02-01