SEC Form 4 · accession 0001513569-16-000019
Forbes Energy Services Ltd. · FLSS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Charles C. Forbes
Officer — Executive Vice President & COO · Director · 10% Owner
Period of report
Oct 1, 2016
Accepted (ET)
Oct 4, 2016 · 3:28 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001434842
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Oct 1, 2016 | M | 29,596 | $0.00 | A | 2,788,249 | D | |
| Common StockF1 | Oct 1, 2016 | D | 29,596 | $0.14 | D | 2,758,653 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Restricted Stock UnitsF1,F2 | — | Oct 1, 2016 | M | 29,596 | D | — | — | Common Stock | 29,596 | 59,194 | D |
Explanation of responses
- F1On October 1, 2016, the reporting person had an award of restricted stock units that vested in accordance with the provisions in a grant made on May 24, 2016. Each restricted stock unit converts into common stock on a one-for-one basis. The restricted stock units were settled in cash valued at $0.14 per share, based on the market closing price on September 30, 2016. No shares were actually, issued, converted, or sold in connection with this transaction.
- F2On May 24, 2016, the reporting person was granted 118,386 restricted stock units, vesting quarterly in four equal installments beginning on July 1, 2016.