-----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, Pz7aDDDwI/A9cx5fL0CjPZoAgypSUpQCAKF6siOFAQEykqgozimv6GQQcHzUoNyt g9C+T6a7FfmfyF3i7RYcsg== 0001209191-04-024729.txt : 20040510 0001209191-04-024729.hdr.sgml : 20040510 20040510171037 ACCESSION NUMBER: 0001209191-04-024729 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040506 FILED AS OF DATE: 20040510 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: 000-19020 FILM NUMBER: 04794073 BUSINESS ADDRESS: STREET 1: 400 E KALISTE SALOOM RD STREET 2: STE 3000 CITY: LAFAYETTE STATE: LA ZIP: 70508 BUSINESS PHONE: 3372327028 MAIL ADDRESS: STREET 1: 400 E KALISTE SALOOM RD STREET 2: STE 3000 CITY: LAFAYETTE STATE: LA ZIP: 70508 4 1 h15316_1amm.xml MAIN DOCUMENT DESCRIPTION X0202 4 2004-05-06 0 0000872248 PETROQUEST ENERGY INC PQUE 0001133135 MIXON ART M III 400 E. KALISTE SALOOM RD. SUITE 6000 LAFAYETTE LA 70508 0 1 0 0 Senior VP - Operations Incentive stock option (right to buy) 3.38 2004-05-06 4 A 0 75000 0 A 2005-05-06 2014-05-05 Common stock 75000 75000 D One third of the shares will vest on each of the first, second and third anniversaries of the grant date. /s/ Arthur M. Mixon III 2004-05-07 -----END PRIVACY-ENHANCED MESSAGE-----