0000899243-20-005055.txt : 20200219 0000899243-20-005055.hdr.sgml : 20200219 20200219164603 ACCESSION NUMBER: 0000899243-20-005055 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200214 FILED AS OF DATE: 20200219 DATE AS OF CHANGE: 20200219 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Roosa Robert M. CENTRAL INDEX KEY: 0001773076 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38870 FILM NUMBER: 20630522 MAIL ADDRESS: STREET 1: 5914 WEST COURTYARD DRIVE STREET 2: SUITE 100 CITY: AUSTIN STATE: TX ZIP: 78730 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Brigham Minerals, Inc. CENTRAL INDEX KEY: 0001745797 STANDARD INDUSTRIAL CLASSIFICATION: CRUDE PETROLEUM & NATURAL GAS [1311] IRS NUMBER: 831106283 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 5914 W. COURTYARD DRIVE STREET 2: SUITE 100 CITY: AUSTIN STATE: TX ZIP: 78730 BUSINESS PHONE: (512) 220-6350 MAIL ADDRESS: STREET 1: 5914 W. COURTYARD DRIVE STREET 2: SUITE 100 CITY: AUSTIN STATE: TX ZIP: 78730 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2020-02-14 0 0001745797 Brigham Minerals, Inc. MNRL 0001773076 Roosa Robert M. 5914 W. COURTYARD DRIVE, SUITE 100 AUSTIN TX 78730 1 1 0 0 Chief Executive Officer Class A Common Stock 2020-02-14 4 A 0 132042 0.00 A 247861 D Class B Common Stock 2020-02-14 4 A 0 65 0.00 A 162537 I See Footnote Class B Common Stock 2020-02-14 4 A 0 121 0.00 A 133102 I See Footnote Brigham Minerals Holdings, LLC Units 0.00 2020-02-14 4 A 0 65 0.00 A Class A Common Stock 65 162537 I See Footnote Brigham Minerals Holdings, LLC Units 0.00 2020-02-14 4 A 0 121 0.00 A Class A Common Stock 121 133102 I See Footnote Award of restricted stock units pursuant to the Brigham Minerals, Inc. 2019 Long Term Incentive Plan. The award vests in three equal installments on December 31, 2020, December 31, 2021 and December 31, 2022, subject to continued employment through each vesting date. Represents shares of Class B common stock distributed to the Reporting Person due to a forfeiture reallocation. Each share of Class B common stock has no economic rights but entitles its holder to one vote on all matters to be voted on by stockholders generally. These securities are held by RSR Resources & Minerals Vested, LLC, of which the Reporting Person is the manager. These securities are held by RSR Resources & Minerals Unvested, LLC, of which the Reporting Person is the manager. Represents units of Brigham Minerals Holdings, LLC ("BMH LLC"), of which the Issuer is the managing member, distributed to the Reporting Person due to a forfeiture reallocation. Subject to the terms of the limited liability company agreement of BMH LLC, such units (together with a corresponding number of shares of Class B common stock) are exchangeable from time to time for shares of Class A common stock of the Issuer. /s/ Robert M. Roosa, by Blake C. Williams as Attorney-in-Fact 2020-02-14