SEC Form 4 · accession 0001610549-17-000005
FIELDPOINT PETROLEUM CORP · FPP
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Donald F. Carnes
10% Owner
Period of report
Jan 27, 2017
Accepted (ET)
Jan 31, 2017 · 3:12 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000316736
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Jan 27, 2017 | S | 10,000 | $0.701 | D | 2,542,424 | I | As administrator |
| Common StockF1 | Jan 30, 2017 | S | 10,000 | $0.70 | D | 2,532,424 | I | As administrator |
| Common StockF1 | Jan 31, 2017 | S | 10,000 | $0.702 | D | 2,522,424 | I | As administrator |
| Common StockF2 | holding | — | — | — | 18,150 | I | By Brady Energy Corporation |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WarrantsF1 | $4.00 | Jan 27, 2017 | S | 10,000 | D | Mar 23, 2012 | Mar 23, 2018 | Common Stock | 10,000 | 279,415 | I |
| WarrantsF1 | $4.00 | Jan 30, 2017 | S | 10,000 | D | Mar 23, 2012 | Mar 23, 2018 | Common Stock | 10,000 | 269,415 | I |
| WarrantsF1 | $4.00 | Jan 31, 2017 | S | 10,000 | D | Mar 23, 2012 | Mar 23, 2018 | Common Stock | 10,000 | 259,415 | I |
Explanation of responses
- F1As administrator of the Estate of Rayford Darell Reaves, Jr.
- F2The Estate of Rayford Darell Reaves, Jr. owns 100% of Brady Energy Corporation.