SEC Form 4 · accession 0000899243-17-004595
Carbon Energy Corp · CRBO
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Peter A Leidel
Director
Period of report
Feb 15, 2017
Accepted (ET)
Feb 17, 2017 · 6:32 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000086264
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | holding | — | — | — | 400,000 | D | ||
| Common StockF1,F2 | holding | — | — | — | 17,938,309 | I | See Footnotes | |
| Common StockF3,F2 | holding | — | — | — | 17,938,309 | I | See Footnotes | |
| Common StockF4,F2 | holding | — | — | — | 22,222,222 | I | See Footnotes |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WarrantF5,F6,F7,F2 | $0.36 | Feb 15, 2017 | P | 30,555,556 | A | Feb 15, 2017 | Feb 15, 2024 | Common Stock | 30,555,556 | 30,555,556 | I |
Explanation of responses
- F1These securities are owned directly by Yorktown Energy Partners V, L.P. The reporting person is a member and a manager of the general partner of Yorktown Energy Partners V, L.P.
- F2The reporting person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and this report shall not be deemed an admission that the reporting person is the beneficial owner of the securities for Section 16 or any other purpose.
- F3These securities are directly owned by Yorktown Energy Partners VI, L.P. The reporting person is a member and a manager of the general partner of the general partner of Yorktown Energy Partners VI, L.P.
- F4These securities are directly owned by Yorktown Energy Partners IX, L.P. The reporting person is a member and a manager of the general partner of the general partner of Yorktown Energy Partners IX, L.P.
- F5The warrant gives Yorktown Energy Partners XI, L.P. ("Yorktown XI") the right to purchase a number of shares of common stock of Carbon Natural Gas Company (the "Issuer") determined, as of the time of exercise, by dividing the aggregate unreturned capital of Yorktown XI's Class A units of Carbon California Company, LLC, a Delaware limited liability company ("CCC"), then held by Yorktown XI by the exercise price then in effect. The number of shares of common stock of the Issuer and the exercise price are subject to certain adjustments from time to time as set forth in the warrant, including adjustments upon the subdivision or combination of shares of common stock of the Issuer, payment of dividends by the Issuer, distributions by CCC, and additional capital contributions made by Yorktown XI to CCC. The amounts set forth above represent the number of shares of common stock and the exercise price as of the date of the issuance of the warrant.
- F6(Continued From Footnote 5) In consideration of the exercise of the warrant, Yorktown XI shall transfer and assign to the Issuer a number of Class A units of CCC in accordance with the formula set forth in the warrant.
- F7These securities are directly owned by Yorktown XI. The reporting person is a member and a manager of the general partner of the general partner of Yorktown XI.