-----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, J8e2gnqA0nbUSZaw5Nuqb4Qd9Q+c+s1FrO9VkBR3rvXMbQd4+Mvxp8v0g2U1DVRc OfKAcImuwl9nqUkUNjJ9lg== 0001209191-03-034625.txt : 20031211 0001209191-03-034625.hdr.sgml : 20031211 20031211171522 ACCESSION NUMBER: 0001209191-03-034625 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031211 FILED AS OF DATE: 20031211 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: NORDBERG E WAYNE CENTRAL INDEX KEY: 0001111624 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19020 FILM NUMBER: 031050082 BUSINESS ADDRESS: STREET 1: 2 WORLD TRADE CENTER 85TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10048 BUSINESS PHONE: 2124324506 MAIL ADDRESS: STREET 1: 2 WORLD TRDE CENTER 85TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10048 4 1 boh11222_1ewn.xml MAIN DOCUMENT DESCRIPTION X0201 42003-12-1100000872248PETROQUEST ENERGY INC PQUE0001111624NORDBERG E WAYNE61 BROADWAY, 31ST FLOORNEW YORKNY100061000Common Stock2003-12-114S0250002.6608D320000DCommon Stock2003-12-114S0220002.655D60160IBy wifeCommon Stock135000IBy Anna & Samuel Nordberg TrustCommon Stock2003-12-114S0350002.6671D85000IBy Olivia S. Nordberg TrustCommon Stock20000IBy Hollow Brook Associates, LLC Deferred Benefit Pension Plan160 of these shares are held in a custodial account (of which Janet Mavec is the custodian) for the benefit of Akasha Mavec/s/ E. Wayne Nordberg2003-12-11 -----END PRIVACY-ENHANCED MESSAGE-----