-----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, MWGZrUd7lFdFPxLNOaMCnxG+Zt/UQm+vRLDSwZo67JXBPwuY3uD53HLxhlmJqfQJ ahN5z4dG9psGANfevNSGaw== 0001209191-04-053941.txt : 20041122 0001209191-04-053941.hdr.sgml : 20041122 20041122105300 ACCESSION NUMBER: 0001209191-04-053941 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20041118 FILED AS OF DATE: 20041122 DATE AS OF CHANGE: 20041122 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: 041159589 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 h20477_ewn1.xml MAIN DOCUMENT DESCRIPTION X0202 4 2004-11-18 0 0000872248 PETROQUEST ENERGY INC PQUE 0001111624 NORDBERG E WAYNE 61 BROADWAY, 31ST FLOOR NEW YORK NY 10006 1 0 0 0 Common Stock 320000 D Common Stock 110160 I By wife Common Stock 3000 I By Delaware Charter Custodian FBO Janet Mavec Common Stock 6000 I By J. Mavec & Co. Ltd. Common Stock 150000 I By Anna & Samuel Nordberg Trust Common Stock 2004-11-18 4 A 0 10000 4.2757 A 110000 I By Olivia S. Nordberg Trust Common Stock 2004-11-18 4 A 0 10000 4.2757 A 40000 I By Hollow Brook Associates, LLC Deferred Benefit Pension Plan Common Stock 2004-11-18 4 A 0 10000 4.20 A 60000 I By E. Wayne Nordberg CGM IRA Custodian Common Stock 10000 I By daughter Common Stock 10000 I By son /s/ E. Wayne Nordberg 2004-11-22 -----END PRIVACY-ENHANCED MESSAGE-----