SEC Form 4 · accession 0001006655-17-000051
EVOLUTION PETROLEUM CORP · EPM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Randall D Keys
Officer — President and CEO
Period of report
Nov 6, 2017
Accepted (ET)
Nov 8, 2017 · 6:44 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001006655
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Nov 6, 2017 | M | 12,931 | $7.20 | A | 264,220 | D | |
| Common StockF2 | Nov 6, 2017 | F | 16,275 | $7.20 | D | 247,945 | D | |
| Common StockF3 | Nov 6, 2017 | A | 26,125 | $0.00 | A | 274,070 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Contingent Performance Stock GrantF1 | $0.00 | Nov 6, 2017 | M | 12,931 | D | — | Dec 4, 2019 | Common Stock | 12,931 | 0 | D |
Explanation of responses
- F1Contingent Restricted Stock award granted on December 4, 2015 that vested upon attainment of a specific performance goal.
- F2Shares surrendered to the Company to pay income tax withholding obligations.
- F3Award of Restricted Stock pursuant to Company's 2016 Equity Incentive Plan, subject to vesting.