Statement of Changes in Beneficial Ownership (4)
March 11 2020 - 3:26PM
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).
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
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Herbers Jeffrey A |
2. Issuer Name and Ticker or Trading Symbol
Cypress Energy Partners, L.P.
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CELP
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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) See Remarks |
(Last)
(First)
(Middle)
C/O CYPRESS ENERGY PARTNERS, L.P., 5727 S. LEWIS AVE., SUITE 300 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
3/9/2020 |
(Street)
TULSA, OK 74105
(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 Units (Limited Partner Interests) | 3/9/2020 | | M | | 2503 | A | (1) | 10668 | D | |
Common Units (Limited Partner Interests) | 3/9/2020 | | F | | 713 | D | $6.30 | 9955 | 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 |
Phantom Units (Limited Partner Interests) | (1) | 3/9/2020 | | M | | | 2503 | (2) | (3) | Common Units (Limited Partner Interests) | 2503 | (1) | 5008 | D | |
Explanation of Responses: |
(1) | Each phantom unit is the economic equivalent of one common unit. |
(2) | On March 9, 2017, the Reporting Person was granted 7,511 phantom units which vest in equal installments on March 9, 2020, 2021 and 2022, subject to Reporting Person's continued service with the Issuer through the applicable vesting dates. |
(3) | The phantom units expire upon settlement. The phantom units are settled upon vesting in common units (on a one-for-one basis) or in cash, at the desertion of the Issuer. |
Remarks: The Reporting Person is Chief Financial Officer of Cypress Energy Partners GP, LLC, the general partner of the Issuer (the "General Partner"). The Issuer is managed by the directors and executive officers of the General Partner. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Herbers Jeffrey A C/O CYPRESS ENERGY PARTNERS, L.P. 5727 S. LEWIS AVE., SUITE 300 TULSA, OK 74105 |
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| See Remarks |
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Signatures
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/s/ Jonathan M. Cinocca, Attorney-in-Fact for Jeffrey A. Herbers | | 3/11/2020 |
**Signature of Reporting Person | Date |
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