SEC Form 4 · accession 0001104659-16-159101
Amplify Energy Corp. · AMPY
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Neal P Goldman
Director
Period of report
Nov 23, 2016
Accepted (ET)
Nov 25, 2016 · 4:20 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001533924
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Restricted Stock UnitF1,F2 | — | Nov 23, 2016 | A | 8,901 | A | — | — | Common Stock | 8,901 | 8,901 | D |
| Restricted Stock UnitF1,F3 | — | Nov 23, 2016 | A | 12,716 | A | — | — | Common Stock | 12,716 | 21,617 | D |
Explanation of responses
- F1Each restricted stock unit represents a contingent right to receive one share of the Issuer's common stock.
- F2Pursuant to the Issuer's 2016 Long Term Incentive Plan (the "Plan"), the Reporting Person received an award of restricted stock units which will vest on the first to occur of (i) December 31, 2017, (ii) the date the Reporting Person ceases to be a director of the board of directors of the Issuer (other than for cause), (iii) the Reporting Person's death, (iv) the Reporting Person's disability or (v) a change in control of the Issuer. Subject to certain exceptions, delivery shall be made within ten days following the applicable vesting date.
- F3Pursuant to the Plan, the Reporting Person received an award of restricted stock units which will vest (i) on the first business day following the date on which the trailing 60 day average share price (including any dividends paid) of the Issuer's common stock is equal to or greater than $30.00 or (ii) upon a change in control of the Issuer. Subject to certain exceptions, delivery shall be made within ten days following the applicable vesting date.