-----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, Lbh/FNjlgiStxIqWePUMc8JO2/1hQDjfE9JZub9QdNLaxtTntPderKlJK3X1U4sG A3BNArVolJDQ2gLGcx6/HQ== 0001005477-99-004413.txt : 19990922 0001005477-99-004413.hdr.sgml : 19990922 ACCESSION NUMBER: 0001005477-99-004413 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19990914 FILED AS OF DATE: 19990921 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 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: SEC FILE NUMBER: 000-19020 FILM NUMBER: 99714430 BUSINESS ADDRESS: STREET 1: 625 E KALISTE SALOOM ROAD SUITE 400 CITY: LAFAYETTE STATE: LA ZIP: 70508 BUSINESS PHONE: 3182327028 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: GARCIA FRANCISCO A CENTRAL INDEX KEY: 0001011849 STANDARD INDUSTRIAL CLASSIFICATION: UNKNOWN SIC - 0000 [0000] DIRECTOR IRS NUMBER: 261967600 STATE OF INCORPORATION: FL FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: C/O CRAMER ROSENTHAL MACGLYNN LLC STREET 2: 520 MADISON AVE 32ND FL CITY: NEW YORK STATE: NY ZIP: 10022 BUSINESS PHONE: 3053613189 MAIL ADDRESS: STREET 1: C/O CRAMER ROSENTHAL STREET 2: 520 MADISON AVE 32ND FL CITY: NEW YORK STATE: NY ZIP: 10022 3 1 FORM 3 U.S. SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 FORM 3 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* Garcia Francisco A. - -------------------------------------------------------------------------------- (Last) (First) (Middle) c/o Cramer Rosenthal McGlynn, LLC 520 Madison Avenue, 32nd Floor - -------------------------------------------------------------------------------- (Street) New York New York 10022 - -------------------------------------------------------------------------------- (City) (State) (Zip) - -------------------------------------------------------------------------------- 2. Date of Event Requiring Statement (Month/Day/Year) 9/14/99 - -------------------------------------------------------------------------------- 3. IRS Identification Number of Reporting Person, if an entity (Voluntary) - -------------------------------------------------------------------------------- 4. Issuer Name and Ticker or Trading Symbol PetroQuest Energy, Inc. (PQUE) - -------------------------------------------------------------------------------- 5. Relationship of Reporting Person to Issuer (Check all applicable) |X| Director |_| 10% Owner |_| Officer (give title below) |_| Other (specify below) ________________________________________ - -------------------------------------------------------------------------------- 6. If Amendment, Date of Original (Month/Day/Year) - -------------------------------------------------------------------------------- 7. Individual or Joint/Group Filing (Check applicable line) |_| Form filed by One Reporting Person |_| Form filed by More than One Reporting Person ================================================================================ - -------------------------------------------------------------------------------- Table I -- Non-Derivative Securities Beneficially Owned - --------------------------------------------------------------------------------
3. Ownership Form: 2. Amount of Securities Direct (D) or 1. Title of Security Beneficially Owned Indirect (I) 4. Nature of Indirect Beneficial Ownership (Instr. 4) (Instr. 5) (Instr. 5) (Instr. 5) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock, par value $0.001 per share 40,000 (D) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. * If the Form is filed by more than one Reporting Person see instruction 5(b)(v). 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 control number. (over) FORM 3 (continued) Table II -- Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
- ------------------------------------------------------------------------------------------------------------------------------------ 5. Owner- 3. Title and Amount of Securities ship Underlying Derivative Security Form of 2. Date Exercisable (Instr. 4) Derivative and Expiration Date --------------------------------- 4. Conver- Security: (Month/Day/Year) Amount sion or Direct 7. Nature of ---------------------- or Exercise (D) or Indirect Date Expira- Number Price of Indirect Beneficial 1. Title of Derivative Exer- tion of Derivative (I) Ownership Security (Instr. 4) cisable Date Title Shares Security (Instr. 5) (Instr. 5) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock Warrants 8/3/99 8/2/03 Common Stock, par 20,000 $1.25 (D) value $0.001 per share - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: /s/ Francisco A. Garcia 9/20/99 - --------------------------------------------- ----------------------- ** 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 provided 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 control number. Page 2 -----END PRIVACY-ENHANCED MESSAGE-----