0001209191-12-027541.txt : 20120511
0001209191-12-027541.hdr.sgml : 20120511
20120511101513
ACCESSION NUMBER: 0001209191-12-027541
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20120509
FILED AS OF DATE: 20120511
DATE AS OF CHANGE: 20120511
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: MITCHELL CHARLES F MD
CENTRAL INDEX KEY: 0001191327
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-32681
FILM NUMBER: 12832535
MAIL ADDRESS:
STREET 1: DEVON ENERGY CORPORATION
STREET 2: 20 N. BROADWAY
CITY: OKLAHOMA CITY
STATE: OK
ZIP: 73102
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
4
1
c28671_4x0.xml
MAIN DOCUMENT DESCRIPTION
X0305
4
2012-05-09
0000872248
PETROQUEST ENERGY INC
PQ
0001191327
MITCHELL CHARLES F MD
400 E. KALISTE SALOOM RD.
SUITE 6000
LAFAYETTE
LA
70508
1
0
0
0
Common Stock
2012-05-09
4
A
0
7500
0
A
283500
D
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/ Charles F. Mitchell
2012-05-09