0000928054-17-000021.txt : 20170214 0000928054-17-000021.hdr.sgml : 20170214 20170214184015 ACCESSION NUMBER: 0000928054-17-000021 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161231 FILED AS OF DATE: 20170214 DATE AS OF CHANGE: 20170214 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FLOTEK INDUSTRIES INC/CN/ CENTRAL INDEX KEY: 0000928054 STANDARD INDUSTRIAL CLASSIFICATION: MISCELLANEOUS CHEMICAL PRODUCTS [2890] IRS NUMBER: 900023731 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 10603 W. SAM HOUSTON PARKWAY N STREET 2: SUITE 300 CITY: HOUSTON STATE: TX ZIP: 77043 BUSINESS PHONE: 7138499911 MAIL ADDRESS: STREET 1: 10603 W. SAM HOUSTON PARKWAY N STREET 2: SUITE 300 CITY: HOUSTON STATE: TX ZIP: 77043 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hardy Carla S. CENTRAL INDEX KEY: 0001576961 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13270 FILM NUMBER: 17612059 MAIL ADDRESS: STREET 1: 10603 W. SAM HOUSTON PKWY N. STREET 2: SUITE 300 CITY: HOUSTON STATE: TX ZIP: 77043 5 1 wf-form5_148711559924280.xml FORM 5 X0306 5 2016-12-31 0 0 0 0000928054 FLOTEK INDUSTRIES INC/CN/ FTK 0001576961 Hardy Carla S. 10603 W. SAM HOUSTON PKWY N. SUITE 300 HOUSTON TX 77064 1 0 0 0 Common Stock 2016-08-24 5 G 0 2795 0 D 192160 I By Carla Shulz Hardy Revocable Trust Common Stock 13813 D Common Stock 66674 I By William M. Hardy V Irrevocable Trust Common Stock 66674 I By Helen G. Hardy Irrevocable Trust Common Stock 66673 I By Sutton N. Hardy Irrevocable Trust Transfer of 12,915 shares from direct ownership to indirect ownership through the Carla Shulz Hardy Revocable Trust. Ms. Hardy is a trustee and beneficiary of the named trust. Ms. Hardy disclaims beneficial ownership of such shares except to the extent of her pecuniary interest therein. Ms. Hardy is neither the trustee nor the beneficiary of the named trusts. Ms. Hardy disclaims beneficial ownership of such shares except to the extent of her pecuniary interest therein. /s/Carla Schultz Hardy 2017-02-14