-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, Ay+uGXkiYWas3KZ5k5UJeSeY2Sfo4uLPSbchT2u2+wlrk2Ln0XLRUA/SW3XripZP 7FcMgU0YUrpzMOY6L5H8Vw== /in/edgar/work/20000705/0000899243-00-001658/0000899243-00-001658.txt : 20000920 0000899243-00-001658.hdr.sgml : 20000920 ACCESSION NUMBER: 0000899243-00-001658 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20000626 FILED AS OF DATE: 20000705 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: FLOTEK INDUSTRIES INC/CN/ CENTRAL INDEX KEY: 0000928054 STANDARD INDUSTRIAL CLASSIFICATION: [5084 ] IRS NUMBER: 770709256 FISCAL YEAR END: 0228 FILING VALUES: FORM TYPE: 3 SEC ACT: SEC FILE NUMBER: 001-13270 FILM NUMBER: 667904 BUSINESS ADDRESS: STREET 1: 7030 EMPIRE CENTRAL DRIVE CITY: HOUSTON STATE: TX ZIP: 928054 BUSINESS PHONE: 7138499911 MAIL ADDRESS: STREET 1: 7030 EMPIRE CENTRAL DRIVE CITY: HOUSTON STATE: TX ZIP: 77040 COMPANY DATA: COMPANY CONFORMED NAME: DUMAS JERRY D SR CENTRAL INDEX KEY: 0001118049 STANDARD INDUSTRIAL CLASSIFICATION: [ ]OFFICER FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: C/O FLOTEK INDUSTRIES INC STREET 2: 7030 EMPIRE CENTRAL CITY: HOUSTON STATE: TX ZIP: 77040 BUSINESS PHONE: 7138499911 MAIL ADDRESS: STREET 1: 5110 SAN FELIPE STREET 2: 148 W. TOWER CITY: HOUSTON STATE: TX ZIP: 77056 3 1 0001.txt FORM 3 FOR JERRY DONALD DUMAS, SR. =============================================================================== /------------------------------/ / OMB APPROVAL / /------------------------------/ / OMB Number: 3235-0104 / / Expires: October 31, 2001 / / Estimated average burden / / hours per response...... 0.5 / /------------------------------/ +--------+ | FORM 3 | U.S. SECURITIES AND EXCHANGE COMMISSION +--------+ WASHINGTON, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 (Print or Type Responses) - -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* DUMAS, SR. JERRY DONALD ---------------------------------------------------------------------------- (Last) (First) (Middle) 5110 SAN FELIPE 148 W. TOWER ---------------------------------------------------------------------------- (Street) HOUSTON TX 77056 ---------------------------------------------------------------------------- (City) (State) (Zip) 2. Date of Event Requiring Statement (Month/Day/Year) JUNE 26, 2000 -------------- 3. IRS Identification Number of Reporting Person if an Entity (Voluntary) ###-##-#### -------------- 4. Issuer Name and Ticker or Trading Symbol FLOTEK INDUSTRIES, INC. "FOTDF" ----------------------------------- 5. Relationship of Reporting Person(s) to Issuer (Check all applicable) ___ Director _X_ Officer ___ 10% Owner ___ Other (give title below) (specify below) CEO/PRESIDENT ---------------------------------------------------------------------------- 6. If Amendment, Date of Original (Month/Day/Year) ---------------------------- 7. Individual or Joint Group Filing (Check Applicable Line) _X__ Form Filed by One Reporting Person ____ Form filed by More than One Reporting Person TABLE I--NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED
- -------------------------------------------------------------------------------- 1. Title 2. Amount of 3. Ownership Form: 4. Nature of of Securities Bene- Direct (D) or Indirect Bene- Security ficially Owned Indirect (I) ficial Ownership (Instr. 4) (Instr. 4) (Instr. 5) (Instr. 5) - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - --------------------------------------------------------------------------------
TABLE II--DERIVATIVE SECURITIES BENEFICIALLY OWNED (e.g., puts, calls, warrants, options, convertible securities)
- ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative 2. Date Exer- 3. Title and Amount of Securities 4. Conversion 5. Ownership 6. Nature of In- Security (Instr. 4) cisable and Underlying Derivative Security or Form of direct Bene- Expiration (Instr. 4) Exercise Derivative ficial Date Price Security: Ownership (Month/Day/ of Direct (D) (Instr. 5) Year) Derivative or In- ---------------------------------------------------- Security direct (I) Date Expira- Amount or (Instr. 5) Exer- tion Title Number of cisable Date Shares - ------------------------------------------------------------------------------------------------------------------------------------ COMMON STOCK 10,000 $.11.5 DIRECT - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - -----------------------------------------------------------------------------------------------------------------------------------
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. Explanation of Responses: Purchased 10,000 shares common stock Jerry Dumas & Nancy Lagow Dumas at $.11.5 cents per share. /s/ Jerry D. Dumas, Sr. June 30, 2000 ------------------------------- ----------------- **Signature of Reporting Person Date * If the form is filed by more than one reported person, see Instruction 5(b)(v). ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, See Instruction 6 for procedure. -----END PRIVACY-ENHANCED MESSAGE-----