0001209191-12-052986.txt : 20121114 0001209191-12-052986.hdr.sgml : 20121114 20121114163058 ACCESSION NUMBER: 0001209191-12-052986 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20121112 FILED AS OF DATE: 20121114 DATE AS OF CHANGE: 20121114 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Price Tracy CENTRAL INDEX KEY: 0001322939 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32681 FILM NUMBER: 121205122 MAIL ADDRESS: STREET 1: C/O PETROQUEST ENERGY, INC. STREET 2: 400 E. KALISTE SALOOM RD, SUITE 6000 CITY: LAFAYETTE STATE: LA ZIP: 70508 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 c30433_4x0.xml MAIN DOCUMENT DESCRIPTION X0306 4 2012-11-12 0000872248 PETROQUEST ENERGY INC PQ 0001322939 Price Tracy 400 E. KALISTE SALOOM RD. SUITE 6000 LAFAYETTE LA 70508 0 1 0 0 Executive VP ? Land Common Stock 2012-11-12 4 A 0 11611 0.00 A 80480 D /s/ Tracy Price 2012-11-13