Statement of Changes in Beneficial Ownership (4)
April 20 2020 - 3:10PM
Edgar (US Regulatory)
FORM 4
[X]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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3235-0287
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
Ver Hoeve Mark Wallace |
2. Issuer Name and Ticker or Trading Symbol
Chaparral Energy, Inc.
[
CHAP
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
__X__ Officer (give title below) _____ Other (specify below)
VP-Geoscience |
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(Last)
(First)
(Middle)
701 CEDAR LAKE BLVD. |
3. Date of Earliest Transaction
(MM/DD/YYYY)
4/17/2020 |
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(Street)
OKLAHOMA CITY, OK 73114
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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| Class A Common Stock | 4/17/2020 | | D | | 22252 | D | (1) | 30754 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. Code
(Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4) | 8. Price of Derivative Security
(Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
| Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
| Restricted Stock Units | $0.0 (2) | 4/17/2020 | | D | | | 125000 | (2)(3) | (2)(3) | Restricted Stock Units | 125000.0 | (2)(3) | 0 (2)(3) | D | |
| Explanation of Responses: |
| (1) | As a result of Mr. Ver Hoeve's retirement as an employee of Chaparral Energy, Inc. (the "Issuer") on April 17, 2020, a total of 22,252 unvested shares of restricted Class A common stock, par value $0.01 per share ("Common Stock"), of the Issuer were forfeited back to the Issuer. This forfeiture is exempt from Sections 16(a) and 16(b) of the Securities Exchange Act of 1934 (the "Exchange Act") pursuant to Rules 16a-4(d) and 16b-6(d), respectively, under the Exchange Act. |
| (2) | Each restricted stock unit ("RSU") represents a contingent right to receive one share of Common Stock upon vesting and settlement. |
| (3) | As a result of Mr. Ver Hoeve's retirement as an employee of the Issuer on April 17, 2020, a total of 125,000 RSUs were forfeited back to the Issuer. Of these forfeited RSUs, 62,500 RSUs would have vested based on passage of time and 62,500 RSUs would have vested based on both passage of time and the achievement of performance thresholds, all granted under the Issuer's 2019 Long-Term Incentive Plan. This forfeiture is exempt from Sections 16(a) and 16(b) of the Exchange Act pursuant to Rules 16a-4(d) and 16b-6(d), respectively, under the Exchange Act. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Ver Hoeve Mark Wallace
701 CEDAR LAKE BLVD.
OKLAHOMA CITY, OK 73114 |
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| VP-Geoscience |
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Signatures
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| /s/ Justin P. Byrne, Attorney-in-Fact | | 4/20/2020 |
| **Signature of Reporting Person | Date |
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