5 1 ma624983_form5.txt ANNUAL STATEMENT OF BENEFICALLY OWNERSHIP ------------------------- ------------------------------ FORM 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION OMB Approval ------------------------- WASHINGTON, D.C. 20549 ------------------------------ [ ] CHECK BOX IF NO OMB Number: 3235-0287 LONGER SUBJECT TO Expires: December 31, 2001 SECTION 16. FORM 4 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Estimated average burden OR FORM 5 OBLIGATIOns hours per response.......0.5 MAY CONTINUE. SEE ------------------------------ INSTRUCTION 1(B). Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, [ ] FORM 3 HOLDINGS Section 17(a) of the Public Utility Holding Company Act of 1935 or REPORTED Section 30(f) of the Investment Company Act of 1940 [X] FORM 4 TRANSACTIONS REPORTED
(Print or Type Responses) ------------------------------------------- ---------------------------------------------- --------------------------------------- 1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) Goodrich Petroleum Corp. (GDP) Malloy Patrick E. [X] Director [X] 10% Owner ------------------------------------------- ------------------------ -------------------- [ ] Officer (give [ ] Other (specify (Last) (First) (Middle) 3. I.R.S. Identification 4. Statement for title below) Number of Reporting Month/Year below) Person, if an entity Malloy Enterprises, Inc. (Voluntary) December 31, 2001 Bay Street at the Waterfront, P.O. Box 1979 ------------------------------------ ------------------------------------------- -------------------- --------------------------------------- (Street) 5. If Amendment, 7. Individual or Joint/Group Filing Date of Original (Check Applicable Line) (Month/Year) [X] Form Filed by One Reporting Person [ ] Form Filed by More than One Sag Harbor NY 11963 Reporting Person ------------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip) TABLE I -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Trans- 3. Transaction 4. Securities Acquired (A) 5. Amount of 6. Ownership 7. Nature of (Instr. 3) action Code (Instr. or Disposed of (D) Securities Form: Indirect Date 8) (Instr. 3, 4 and 5) Beneficially Direct (D) Beneficial (Month/ Owned at End or Indirect Ownership Day/ of Issuer's (I) (Instr. 4) Year) Fiscal Year (Instr. 4) (Instr. 3 and 4) ------------------------------------------------------------------------------------------------------------------------------------ Code V Amount (A) or (D) Price ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 5/18/01 A4 105,000 A $ 5.55 D ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 11/26/01 A4 2,400 A $ 4.51 2,367,876 D ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 11/1/01 A4(1) 74,850 A $ 4.97 74,850 I (1) (1) ------------------------------------------------------------------------------------------------------------------------------------ 1. The Reporting Person became the beneficial owner of shares held in trust for his daughter, Katherine C. Malloy, on November 1, 2001. The Reporting Person disclaims beneficial ownership of all securities held by his daughter's trust. Page 1 SEC 2270 (01-02)
FORM 5 (continued) TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) ------------------------------------------------------------------------------------------------------------------------------------ 1. Title 2. Conver- 3. Trans- 4. Trans- 5. Number of 6. Date 7. Title 8. Price 9. Number 10. Owner- 11. Nature of of sion or action action Derivative Exer- and of of ship of Indirect Deriv- Exercise Date Code Securities cisable Amount Deriv- Deriv- Deriv- Beneficial ative Price of (Month/ (Instr. Acquired (A) and Expir- of ative ative ative Ownership Secu- Deriv- Day/ 8) or Disposed ation Under- Secu- Secu- Security: (Instr. 4) rity ative Year) of (D) Date lying rity rities Direct (Instr. Security (Instr. 3, (Month/ Securi- (Instr. Benefi- (D) or 3) 4, and 5) Day/ ties 5) cially Indirect Year) (Instr. Owned (I) 3 and 4) at End (Instr. of Fiscal 4) Year (Instr. 4) ---------------------------------------------------- Code V (A) (D) Date Expir- Title Amount Exercis- ation or able Date Number of Shares ----------------------------------------------------- Series A $0.4125 2/14/01 P4 5,000 immed. none Common 2,062.50 $8.00 D Convertible Stock Preferred Stock ------------------------------------------------------------------------------------------------------------------------------------ Series A $0.4125 2/15/01 P4 1,600 immed. none Common 660.00 $8.00 D Convertible Stock Preferred Stock ------------------------------------------------------------------------------------------------------------------------------------ Series A $0.4125 2/20/01 P4 2,500 immed. none Common 1,031.25 $8.00 D Convertible Stock Preferred Stock ------------------------------------------------------------------------------------------------------------------------------------ Series A $0.4125 2/21/01 P4 3,000 immed. none Common 1,237.50 8.00 D Convertible Stock Preferred Stock ------------------------------------------------------------------------------------------------------------------------------------ Series A $0.4125 3/1/01 P4 700 immed. none Common 288.75 $8.12 D Convertible Stock Preferred Stock ------------------------------------------------------------------------------------------------------------------------------------ Series A $0.4125 3/8/01 P4 1,000 immed. none Common 412.50 $8.12 D Convertible Stock Preferred Stock ------------------------------------------------------------------------------------------------------------------------------------ Series A $0.4125 6/12/01 P4 5,000 immed. none Common 2,062.50 $9.00 D Convertible Stock Preferred Stock ------------------------------------------------------------------------------------------------------------------------------------ Series A $0.4125 6/13/01 P4 5,000 immed. none Common 2,062.50 $9.00 D Convertible Stock Preferred Stock ------------------------------------------------------------------------------------------------------------------------------------ Series A $0.4125 6/14/01 P4 500 immed. none Common 206.25 $9.00 D Convertible Stock Preferred Stock ------------------------------------------------------------------------------------------------------------------------------------ Series A $0.4125 7/23/01 P4 200 immed. none Common 82.50 $8.90 D Convertible Stock Preferred Stock ------------------------------------------------------------------------------------------------------------------------------------ Series A $0.4125 8/6/01 P4 1,000 immed. none Common 412.50 $8.90 D Convertible Stock Preferred Stock ------------------------------------------------------------------------------------------------------------------------------------ Series A $0.4125 8/15/01 P4 3,280 immed. none Common 1,353.00 $9.00 D Convertible Stock Preferred Stock ------------------------------------------------------------------------------------------------------------------------------------ Series A $0.4125 8/16/01 P4 10,020 immed. none Common 4,133.25 $9.00 D Convertible Stock Preferred Stock Page 2 ------------------------------------------------------------------------------------------------------------------------------------ Series A $0.4125 8/27/01 P4 500 immed. none Common 206.25 $8.99 D Convertible Stock Preferred Stock ------------------------------------------------------------------------------------------------------------------------------------ Series A $0.4125 8/30/01 P4 200 immed. none Common 82.50 $9.00 D Convertible Stock Preferred Stock ------------------------------------------------------------------------------------------------------------------------------------ Series A $0.4125 9/7/01 P4 400 immed. none Common 165.00 $9.00 D Convertible Stock Preferred Stock ------------------------------------------------------------------------------------------------------------------------------------ Series A $0.4125 12/19/01 P4 500 immed. none Common 206.25 $8.60 D Convertible Stock Preferred Stock ------------------------------------------------------------------------------------------------------------------------------------ Series A $0.4125 12/20/01 P4 1,000 immed. none Common 412.50 $9.00 122,850 D Convertible Stock Preferred Stock ------------------------------------------------------------------------------------------------------------------------------------ Series A $0.4125 11/1/01 J4(1) 23,545 immed. none Common 9,712.31 $9.05 23,545 I (1) (1) Convertible Stock Preferred Stock ------------------------------------------------------------------------------------------------------------------------------------ Explanation of Responses: ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. and 15 U.S.C. 78ff(a). Note: File three copies of this Form, one of which must be manually /s/ Patrick E. Malloy 1-10-02 signed. If space is insufficient, see Instruction 6 for ------------------------------------ -------------------- procedure. ** Signature of Reporting Person Date Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. Page 3 SEC 2270 (01-02)