0001209191-12-027540.txt : 20120511
0001209191-12-027540.hdr.sgml : 20120511
20120511100927
ACCESSION NUMBER: 0001209191-12-027540
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20120509
FILED AS OF DATE: 20120511
DATE AS OF CHANGE: 20120511
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: 12832515
MAIL ADDRESS:
STREET 1: 2 WORLD TRDE CENTER 85TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10048
4
1
c28672_4x0.xml
MAIN DOCUMENT DESCRIPTION
X0305
4
2012-05-09
0000872248
PETROQUEST ENERGY INC
PQ
0001111624
NORDBERG E WAYNE
410 PARK AVENUE, 17TH FLOOR
NEW YORK
NY
10022
1
0
0
0
Common stock
2012-05-09
4
A
0
7500
0
A
272500
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
134900
I
By Delaware Charter FBO Wayne Nordberg R/O IRA
Nonstatutory Stock Option (right to buy)
5.50
2012-05-09
4
A
0
7500
0
A
2013-05-09
2022-05-08
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
2012-05-09