0000928054-18-000014.txt : 20180212 0000928054-18-000014.hdr.sgml : 20180212 20180212171707 ACCESSION NUMBER: 0000928054-18-000014 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171231 FILED AS OF DATE: 20180212 DATE AS OF CHANGE: 20180212 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: 18597579 MAIL ADDRESS: STREET 1: 10603 W. SAM HOUSTON PKWY N. STREET 2: SUITE 300 CITY: HOUSTON STATE: TX ZIP: 77043 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 5 1 wf-form5_151847381006565.xml FORM 5 X0306 5 2017-12-31 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 Sotck 24452 D Common Stock 0 I By William M. Hardy V Irrevocable Trust Common Stock 192160 I By Carla Schulz Hardy Revocable Trust Common Stock 66674 I By Helen G. Hardy Irrevocable Trust Common Stock 66673 I By Sutton N. Hardy Irrevocable Trust Ms. Hardy has previously reported a beneficial interest in shares of common stock of the Company held by an irrevocable trust for the benefit of a dependent child. This child is no longer a dependent of Ms. Hardy and, as a result, Ms. Hardy no longer has any beneficial interest in the shares of common stock of the Company owned by the trust and such shares are no longer included herein. 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 Schulz Hardy 2018-02-12