0001209191-13-052555.txt : 20131115 0001209191-13-052555.hdr.sgml : 20131115 20131115163043 ACCESSION NUMBER: 0001209191-13-052555 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20131112 FILED AS OF DATE: 20131115 DATE AS OF CHANGE: 20131115 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: 131224250 MAIL ADDRESS: STREET 1: 2 WORLD TRDE CENTER 85TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10048 4 1 c627956_4x0.xml MAIN DOCUMENT DESCRIPTION X0306 4 2013-11-12 0000872248 PETROQUEST ENERGY INC PQ 0001111624 NORDBERG E WAYNE 410 PARK AVENUE, 17TH FLOOR NEW YORK NY 10022 1 0 0 0 Common stock 2013-11-12 4 M 0 40000 3.17 A 347500 D Common stock 90060 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) 3.17 2013-11-12 4 M 0 40000 0 D 2004-01-26 2014-01-25 Common stock 40000 0 D 20,000 shares vested on January 26, 2004; 6,667 shares vested on April 30, 2004; 6,667 shares vested on May 23, 2004; and 6,666 shares vested on April 30, 2005. /s/ E. Wayne Nordberg 2013-11-13