Statement of Changes in Beneficial Ownership (4)
12 Março 2019 - 6:44PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
hours per response...
0.5
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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
*
MCCARTHY TIMOTHY P
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2. Issuer Name
and
Ticker or Trading Symbol
HORNBECK OFFSHORE SERVICES INC /LA
[
HOS
]
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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)
SVP & Chief Human Resources Of
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(Last)
(First)
(Middle)
103 NORTHPARK BLVD, SUITE 300
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3. Date of Earliest Transaction
(MM/DD/YYYY)
3/8/2019
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(Street)
COVINGTON, LA 70433
(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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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)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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PHANTOM STOCK
(1)
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(1)
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3/8/2019
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A
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233654
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(1)
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3/8/2022
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COMMON STOCK
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233654
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$0.00
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233654
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D
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STOCK APPRECIATION RIGHTS
(2)
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$1.38
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3/8/2019
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A
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155769
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(2)
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3/8/2029
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COMMON STOCK
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155769
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$0.00
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155769
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D
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Explanation of Responses:
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(1)
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The phantom stock units vest in three equal annual installments on each of the 1st, 2nd and 3rd anniversaries of the grant date. Each phantom stock
unit represents the right to receive, upon settlement, the economic equivalent of one share of the Company's common stock. Phantom stock units may be
settled in shares of Company common stock, cash, or a combination thereof (at the election of the issuer)
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(2)
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The stock appreciation rights vest and become exercisable in three equal annual installments on each of the 1st, 2nd and 3rd anniversaries of the grant
date. The stock appreciation rights represent the right to receive, upon exercise, a number of shares of Company common stock, cash, or a
combination thereof (at the election of the issuer) equal to the product of the aggregate number of shares of Company common stock with respect to
which the stock appreciation right award is exercised and the excess of the fair market value of a share of Company common stock as of the date of
exercise over the base price specified above.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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MCCARTHY TIMOTHY P
103 NORTHPARK BLVD, SUITE 300
COVINGTON, LA 70433
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SVP & Chief Human Resources Of
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Signatures
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/s/ Beth A. LaBrosse, as POA for Timothy P. McCarthy
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3/12/2019
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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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