-----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, R2xtfsv8ANfdOV20b9h24etF0/P+rheYfu4WM8SmoYUYok92PxDIwLXb/KjK2rst wa1ztXN1utvdEs/YReqJZg== 0001209191-10-027630.txt : 20100513 0001209191-10-027630.hdr.sgml : 20100513 20100513165329 ACCESSION NUMBER: 0001209191-10-027630 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20100512 FILED AS OF DATE: 20100513 DATE AS OF CHANGE: 20100513 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: 001-32681 FILM NUMBER: 10829301 MAIL ADDRESS: STREET 1: 2 WORLD TRDE CENTER 85TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10048 4 1 c01003_4x0.xml MAIN DOCUMENT DESCRIPTION X0303 4 2010-05-12 0000872248 PETROQUEST ENERGY INC PQ 0001111624 NORDBERG E WAYNE 551 MADISON AVENUE, 8TH FLOOR NEW YORK NY 10022 1 0 0 0 Common stock 2010-05-12 4 A 0 7500 0 A 257500 D Common stock 90090 I By wife Common stock 79950 I By Anna & Samuel Nordberg Trust Common stock 64950 I By Olivia S. Nordberg Trust Common stock 4950 I By Hollow Brook Associates, LLC Deferred Benefit Pension Plan Common stock 129950 I By Delaware Charter FBO Wayne Nordberg R/O IRA Nonstatutory Stock Option (right to buy) 6.29 2010-05-12 4 A 0 7500 0 A 2011-05-12 2020-05-12 Common Stock 7500 7500 D One third of the shares will vest on each of the first, second and third anniversaries of the grant date. /s/ Lillian Preziosi, Attorney-in-Fact 2010-05-12 -----END PRIVACY-ENHANCED MESSAGE-----