Initial Statement of Beneficial Ownership (3)
May 09 2022 - 04:08PM
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
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 *
Collins Steven C. |
2. Date of Event Requiring Statement
(MM/DD/YYYY)
4/29/2022
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3. Issuer Name and Ticker or Trading
Symbol EARTHSTONE ENERGY INC [ESTE] |
(Last)
(First)
(Middle)
1400 WOODLOCH FOREST DR., SUITE 300 |
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)_____
Director _____
10% Owner
___X___ Officer (give title
below) _____
Other (specify below)
EVP and COO / |
(Street)
THE
WOODLANDS, TX 77380
(City)
(State)
(Zip)
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5. 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 |
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) |
Class A Common Stock |
343899 (1) |
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. 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 Unit |
(2) |
12/31/2023 |
Class A Common Stock |
144000.0 |
(2) |
D |
|
Performance Unit |
(3) |
12/31/2024 |
Class A Common Stock |
63765.0 |
(3) |
D |
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Explanation of
Responses: |
(1) |
Includes 73,750 restricted
stock units ("RSUs") that are subject to the terms of restricted
stock unit agreements and vest as to 11,620 RSUs on June 30, 2022,
11,620 RSUs on September 30, 2022, 11,620 RSUs on December 31,
2022, 6,861 RSUs on March 31, 2023, 6,861 RSUs on June 30, 2023,
6,862 RSUs on September 30, 2023, 6,861 RSUs on December 31, 2023,
2,861 RSUs on March 31, 2024, 2,861 RSUs on June 30, 2024, 2,861
RSUs on September 30, 2024 and 2,861 RSUs on December 31, 2024.
Each RSU represents the contingent right to receive one share of
Class A common stock of the Issuer. |
(2) |
This performance unit award
is subject to the terms of the performance unit agreement. The
vesting of the award is subject to the satisfaction of certain
performance criteria in the period beginning January 1, 2021 and
ending December 31, 2023. The units are valued on a one-to-one
basis to the Class A common stock of the Issuer and are intended to
be settled in cash but may be settled in stock upon vesting. The
number of shares of Class A common stock applicable to the award
can range from 0% to 200% of the number presented
above. |
(3) |
This performance unit award
is subject to the terms of the performance unit agreement. The
vesting of the award is subject to the satisfaction of certain
performance criteria in the period beginning January 1, 2022 and
ending December 31, 2024. The units are valued on a one-to-one
basis to the Class A common stock of the Issuer and are intended to
be settled in cash but may be settled in stock upon vesting. The
number of shares of Class A common stock applicable to the award
can range from 0% to 200% of the number presented
above. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
Collins Steven C.
1400 WOODLOCH FOREST DR., SUITE 300
THE WOODLANDS, TX 77380 |
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|
EVP and COO |
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Signatures
|
/s/ Steven C. Collins |
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5/9/2022 |
**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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