-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, C8IwnUrRM0E++YUtXbjTi58Zaa4R/5KwUNpV4TcmI5TXD+UwhJeAuS5dMGhOiFtn CRKoLxTptx2Ot68/8Ev53w== 0000950129-01-501285.txt : 20010612 0000950129-01-501285.hdr.sgml : 20010612 ACCESSION NUMBER: 0000950129-01-501285 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20010508 FILED AS OF DATE: 20010611 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: PETROQUEST ENERGY INC CENTRAL INDEX KEY: 0000872248 STANDARD INDUSTRIAL CLASSIFICATION: CRUDE PETROLEUM & NATURAL GAS [1311] IRS NUMBER: 980115468 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 000-19020 FILM NUMBER: 1658170 BUSINESS ADDRESS: STREET 1: 400 E KALISTE SALOOM RD SUITE 3000 CITY: LAFAYETTE STATE: LA ZIP: 70508 BUSINESS PHONE: 3372327028 MAIL ADDRESS: STREET 1: 600 595 HOWE ST STREET 2: VANCOUVER BRITISH COLUMBIA CITY: CANADA V6C 2T5 STATE: A1 FORMER COMPANY: FORMER CONFORMED NAME: OPTIMA PETROLEUM CORP DATE OF NAME CHANGE: 19950726 COMPANY DATA: COMPANY CONFORMED NAME: ALDRIDGE MICHAEL O CENTRAL INDEX KEY: 0001116045 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: C/O PETROQUEST ENERGY INC STREET 2: 400 E. KALISTE SALOOM RD. #3000 CITY: LAFAYETTE STATE: LA ZIP: 70508 BUSINESS PHONE: 3372327028 MAIL ADDRESS: STREET 1: C/O PETROQUEST ENERGY INC STREET 2: 400 E KALISTE SALOOM RD. #3000 CITY: LAFAYETTE STATE: IN ZIP: 70508 4 1 h88128de4.txt MICHAEL O. ALDRIDGE FOR PQUE 1 -------------------------- OMB APPROVAL -------------------------- - -------- OMB Number: 3235-0104 FORM 3 Expires: December 31, 2001 - -------- Estimated average burden hours per response.... 0.5 -------------------------- U.S. SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 - ----------------------------------------------------------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* 2. Date of Event Requiring 4. Issuer Name and Ticker or 6. If Amendment, Date Statement Trading Symbol of Original Aldridge Michael O. (Month/Day/Year) PetroQuest Energy, Inc. (PQUE) (Month/Day/Year) - ---------------------------------------- ------------------------------------ 6/1/00 (Last) (First) (Middle) 5/23/00 5. Relationship of Reporting ----------------------- ---------------------------- Person(s) to Issuer 7. Individual or Joint/ 400 E. Kaliste Saloom Road, Suite 3000 3. I.R.S. or Social (Check all applicable) Group Filing (Check - ---------------------------------------- Security Number of X Director 10% Owner Applicable Line) (Street) Reporting Person ----- ----- X Form filed by (Voluntary) X Officer Other (specify --- One Reporting Lafayette Louisiana 77508 ----- ----- below) Person - -------------------------------------- ---------------------------- (give title below) Form filed by (City) (State) (Zip) --- More than One Senior Vice President, Chief Reporting Person Financial Officer and Secretary ------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- TABLE I -- NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED - ----------------------------------------------------------------------------------------------------------------------------------- 1. Title of Security 2. Amount of Securities 3. Ownership Form: 4. Nature of Indirect (Instr. 4) Beneficially Owned Direct (D) or Beneficial (Instr. 4) Indirect (I) Ownership (Instr. 5) (Instr. 5) - ----------------------------------------------------------------------------------------------------------------------------------- Common Stock 27,783 D - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over) *If the form is filed by more than one reporting person, see Instruction 5(b)(v). SEC 1473 (7-96)
2
- ------------------------------------------------------------------------------------------------------------------------------------ FORM 3 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES BENEFICIALLY OWNED (e.g., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative 2. Date Exercisable 3. Title and Amount of 4. Conversion 5. Ownership 6. Nature of Indirect Security (Instr. 4) and Expiration Securities Underlying or Exercise Form of Beneficial Ownership Date Derivative Security Price of Derivative (Instr. 5) (Month/Day/Year) (Instr. 4) Derivative Security: ------------------------------------------------- Security Direct (D) or Amount or Indirect (I) Date Expiration Number (Instr. 5) Exercisable Date Title of Shares - ------------------------------------------------------------------------------------------------------------------------------------ Incentive Stock Options pursuant to 1998 Common Incentive Plan 5/8/00 5/7/10 Stock 100,000 $1.5625 D - ------------------------------------------------------------------------------------------------------------------------------------ Call Option Common (right to buy) (1) 5/8/05 Stock 122,250 $1.75 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ Explanation of Responses: 1. THE OPTION VESTS AS TO 1/3 OF THE 122,250 SHARES OF COMMON STOCK /s/ MICHAEL O. ALDRIDGE 6/6/01 ON EACH OF THE FIRST, SECOND AND THIRD ANNIVERSARIES OF THE ---------------------------------- ----------- GRANT DATE. **Signature of Reporting Person Date
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, See Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number. -----END PRIVACY-ENHANCED MESSAGE-----