Initial Statement of Beneficial Ownership (3)
23 Fevereiro 2023 - 6:14PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
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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
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Bunch John Mark |
2. Date of Event Requiring Statement (MM/DD/YYYY)
2/21/2023
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3. Issuer Name and Ticker or Trading Symbol
EVOLUTION PETROLEUM CORP [EPM]
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(Last)
(First)
(Middle)
1155 DAIRY ASHFORD ROAD, SUITE 425 |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director _____ 10% Owner
___X___ Officer (give title below) _____ Other (specify below)
COO / |
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(Street)
HOUSTON, TX 77079
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 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 Beneficially Owned
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1.Title of Security
(Instr. 4) | 2. Amount of Securities Beneficially Owned
(Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5) | 4. Nature of Indirect Beneficial Ownership
(Instr. 5) |
| Common Stock | 93562 (1) | D |
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 4) | 2. Date Exercisable and Expiration Date
(MM/DD/YYYY) | 3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5) | 6. Nature of Indirect Beneficial Ownership
(Instr. 5) |
| Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
| Performance Stock Unit | (2) | 6/30/2025 | Common Stock | 4521 | $0 (2) | D |
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| Explanation of Responses: |
| (1) | Awards of Restricted Stock acquired through grant on February 21, 2023 pursuant to the Company's 2016 Equity Incentive Plan, subject to vesting terms and performance goals. |
| (2) | Award of performance stock units ("PSUs") acquired through grant on February 21, 2023 pursuant to the Company's 2016 Equity Incentive Plan. Each PSU represents a contingent right to receive one share of Issuer's common stock, subject to the attainment of performance goals and other vesting criteria. Common shares of stock will not be issued until the performance goals and other vesting criteria have been achieved. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Bunch John Mark
1155 DAIRY ASHFORD ROAD
SUITE 425
HOUSTON, TX 77079 |
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| COO |
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Signatures
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| /s/ John Mark Bunch | | 2/23/2023 |
| **Signature of Reporting Person | Date |
| Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
| * | If the form is filed by more than one reporting person, see Instruction 5(b)(v). |
| ** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
| Note: | File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. |
| Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. |
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