Statement of Changes in Beneficial Ownership (4)
February 21 2018 - 4:43PM
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
*
HORNBECK TODD M
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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)
__
X
__ Director
_____ 10% Owner
__
X
__ Officer (give title below)
_____ Other (specify below)
President & CEO
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(Last)
(First)
(Middle)
103 NORTHPARK BOULEVARD, SUITE 300
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3. Date of Earliest Transaction
(MM/DD/YYYY)
2/16/2018
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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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COMMON STOCK
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2/16/2018
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M
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47339
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A
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(1)
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976769
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D
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COMMON STOCK
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2/16/2018
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D
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47339
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D
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$3.57
(1)
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929430
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D
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COMMON STOCK
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2/16/2018
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F
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13918
(2)
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D
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$3.73
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915512
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D
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COMMON STOCK
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42511
(3)
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I
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By Limited Partnership
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COMMON STOCK
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1650
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I
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By Wife
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COMMON STOCK
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70000
(4)
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I
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By Family Trusts
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COMMON STOCK
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70
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I
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By UTMA custodian for child
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COMMON STOCK
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220
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I
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By IRA
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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
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(1)
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2/16/2018
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M
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47339
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(1)
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(1)
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COMMON STOCK
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47339
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(1)
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47339
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D
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Explanation of Responses:
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(1)
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Represents the one-third vesting and cash settlement of a time-vest phantom restricted stock unit award with a Grant Date of February 16, 2016. Each phantom unit is the economic equivalent of one share of the Company's Common Stock. The phantom shares are payable in cash or stock at the election of the Company. Cash awards are based on a 10 day trailing average of the market price of the Company's stock on the vesting date. No shares were actually issued, converted, or sold in connection with this transaction.
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(2)
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Disposition of these shares represents payment of tax liability by delivering or withholding securities incident to the vesting of a restricted stock award issued in accordance with Rule 16b-3.
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(3)
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Represents shares beneficially owned by Reporting Person through a Family Limited Partnership
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(4)
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Represents shares beneficially owned by Reporting Person through various family trusts.
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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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HORNBECK TODD M
103 NORTHPARK BOULEVARD, SUITE 300
COVINGTON, LA 70433
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X
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President & CEO
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Signatures
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/s/ Beth A. LaBrosse as POA for Todd M. Hornbeck
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2/21/2018
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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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