0000872248-16-000220.txt : 20161115
0000872248-16-000220.hdr.sgml : 20161115
20161115145605
ACCESSION NUMBER: 0000872248-16-000220
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20161112
FILED AS OF DATE: 20161115
DATE AS OF CHANGE: 20161115
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: PETROQUEST ENERGY INC
CENTRAL INDEX KEY: 0000872248
STANDARD INDUSTRIAL CLASSIFICATION: CRUDE PETROLEUM & NATURAL GAS [1311]
IRS NUMBER: 721440714
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 400 E KALISTE SALOOM RD SUITE 6000
CITY: LAFAYETTE
STATE: LA
ZIP: 70508
BUSINESS PHONE: 3372327028
MAIL ADDRESS:
STREET 1: 400 E KALISTE SALOOM RD SUITE 6000
CITY: LAFAYETTE
STATE: LA
ZIP: 70508
FORMER COMPANY:
FORMER CONFORMED NAME: OPTIMA PETROLEUM CORP
DATE OF NAME CHANGE: 19950726
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: MIXON ART M III
CENTRAL INDEX KEY: 0001133135
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-32681
FILM NUMBER: 161999310
MAIL ADDRESS:
STREET 1: 400 E KALISTE SALOOM RD
STREET 2: STE 3000
CITY: LAFAYETTE
STATE: LA
ZIP: 70508
4
1
wf-form4_147923975174227.xml
FORM 4
X0306
4
2016-11-12
0
0000872248
PETROQUEST ENERGY INC
PQ
0001133135
MIXON ART M III
400 E. KALISTE SALOOM RD.
SUITE 6000
LAFAYETTE
LA
70508
0
1
0
0
Exec VP - Operations and Prod
Common Stock
2016-11-12
4
M
0
7998
0
A
126406
D
Common Stock
2016-11-12
4
F
0
2596
3.20
D
123810
D
Common Stock
2016-11-12
4
F
0
1771
3.20
D
122039
D
Restricted Stock Units
2016-11-12
4
M
0
7998
0
D
Common Stock
7998.0
7999
D
Each Restricted Stock Unit represents a continent right to receive one share of PetroQuest common stock.
The number of shares acquired and the number of shares beneficially owned following the transaction have been adjusted to reflect the one for four reverse split of the common stock effective May 18, 2016 (the "Reverse Split"). Also includes 2,520 and 6,574 post Reverse Split shares acquired under PetroQuest's employee stock purchase plan on January 31, 2016 and July 31, 2016, respectively.
On November 12, 2014 the reporting person was granted 23,996 post Reverse Split Restricted Stock Units. One third of the Restricted Stock Units vest on each of the first, second and third anniversaries of the grant date. The applicable number of shares of PetroQuest common stock will be delivered to the reporting person on each such vesting date.
/s/ Arthur M. Mixon III
2016-11-15