0000928054-22-000054.txt : 20220323 0000928054-22-000054.hdr.sgml : 20220323 20220323163002 ACCESSION NUMBER: 0000928054-22-000054 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220321 FILED AS OF DATE: 20220323 DATE AS OF CHANGE: 20220323 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Nierenberg David CENTRAL INDEX KEY: 0001040899 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13270 FILM NUMBER: 22763540 MAIL ADDRESS: STREET 1: 19605 NE 8TH STREET CITY: CAMAS STATE: WA ZIP: 98607 FORMER NAME: FORMER CONFORMED NAME: NIERENBERG DAVID DATE OF NAME CHANGE: 19970611 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: 8846 N. SAM HOUSTON PARKWAY W. CITY: HOUSTON STATE: TX ZIP: 77064 BUSINESS PHONE: 7138499911 MAIL ADDRESS: STREET 1: 8846 N. SAM HOUSTON PARKWAY W. CITY: HOUSTON STATE: TX ZIP: 77064 4 1 wf-form4_164806738493581.xml FORM 4 X0306 4 2022-03-21 0 0000928054 FLOTEK INDUSTRIES INC/CN/ FTK 0001040899 Nierenberg David 8846 N. SAM HOUSTON PKWY W. HOUSTON TX 77064 1 0 0 0 Common Shares 2022-03-21 4 C 0 1036214 0 A 2595383 I By The D3 Family Fund, LP Common Shares 2022-03-21 4 C 0 1680008 0 A 4795960 I By The D3 Family Bulldog Fund, LP Common Shares 2022-03-21 4 C 0 76808 0 A 242656 I By Haredale Ltd. Convertible Debt 1.0881 2022-03-21 4 C 0 1127530.83 D 2022-02-02 2023-02-02 Common Shares 1127530.83 0 I D3 Family Fund, LP Convertible Debt 1.0881 2022-03-21 4 C 0 1828058.75 D 2022-02-02 2023-02-03 Common Shares 1828058.75 0 I D3 Family Bulldog Fund, LP Convertible Debt 1.0881 2022-03-21 4 C 0 83577.08 D 2022-02-02 2023-02-02 Common Shares 83577.08 0 I Haredale Limited Shares from conversion of convertible debt listed in Table II. Includes 10% PIK interest accrued through the date prior to the conversion date. Convertible Debt was purchased on Feb 2, 2022 by The D3 Family Fund, LP, the D3 Family Bulldog Fund, LP and Haredale Ltd. for a cumulative amount of $3,000,000 10% PIK convertible debt issued on Feb 2, 2022 was converted early on Mar 21, 2022 at a conversion price of $1.088125. /s/ Nicholas J. Bigney, attorney-in-fact 2022-03-23