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