0000872248-17-000043.txt : 20170522
0000872248-17-000043.hdr.sgml : 20170522
20170522125831
ACCESSION NUMBER: 0000872248-17-000043
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170518
FILED AS OF DATE: 20170522
DATE AS OF CHANGE: 20170522
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: MITCHELL CHARLES F MD
CENTRAL INDEX KEY: 0001191327
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-32681
FILM NUMBER: 17860356
MAIL ADDRESS:
STREET 1: DEVON ENERGY CORPORATION
STREET 2: 20 N. BROADWAY
CITY: OKLAHOMA CITY
STATE: OK
ZIP: 73102
4
1
wf-form4_149547229667895.xml
FORM 4
X0306
4
2017-05-18
0
0000872248
PETROQUEST ENERGY INC
PQ
0001191327
MITCHELL CHARLES F MD
400 EAST KALISTE SALOOM ROAD #6000
LAFAYETTE
LA
70508
1
0
0
0
Common Stock
2017-05-18
4
A
0
7500
0
A
89000
D
The number of shares beneficially owned following the transaction have been adjusted to reflect the one for four reverse split of the common stock effetive May 18, 2016.
Shares will vest on the earlier of May 18, 2018 or the day of the 2018 annual meeting of stockholders.
/s/ Charles F. Mitchell
2017-05-18