SEC Form 5
FORM 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
  
Form 3 Holdings Reported.
X
Form 4 Transactions Reported.
1. Name and Address of Reporting Person*
QA Global GP, LLC

(Last) (First) (Middle)
1401 MCKINNEY STREET, SUITE 2400

(Street)
HOUSTON TX 77010

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
QR Energy, LP [ QRE ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
Officer (give title below) X Other (specify below)
Fund Entity
3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year)
12/31/2012
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned at end of Issuer's Fiscal Year (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Amount (A) or (D) Price
Common Units 12/22/2012 M4 7,145,866 A $0 0 I See footnote(1)(2)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction 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 (Month/Day/Year) 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: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
(A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Subordinated units $0(2) 12/22/2012 4M 7,145,866 (2) (2) Common units 7,145,866 (2) 0 I See footnote(1)
1. Name and Address of Reporting Person*
QA Global GP, LLC

(Last) (First) (Middle)
1401 MCKINNEY STREET, SUITE 2400

(Street)
HOUSTON TX 77010

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director 10% Owner
Officer (give title below) X Other (specify below)
Fund Entity
1. Name and Address of Reporting Person*
Black Diamond Resources 2, LLC

(Last) (First) (Middle)
1401 MCKINNEY STREET, SUITE 2400

(Street)
HOUSTON TX 77010

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director 10% Owner
Officer (give title below) X Other (specify below)
Fund Entity
1. Name and Address of Reporting Person*
QA Holdings, LP

(Last) (First) (Middle)
1401 MCKINNEY STREET, SUITE 2400

(Street)
HOUSTON TX 77010

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director 10% Owner
Officer (give title below) X Other (specify below)
Fund Entity
1. Name and Address of Reporting Person*
QA GP, LLC

(Last) (First) (Middle)
1401 MCKINNEY STREET, SUITE 2400

(Street)
HOUSTON TX 77010

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director 10% Owner
Officer (give title below) X Other (specify below)
Fund Entity
1. Name and Address of Reporting Person*
Quantum Aspect Partnership, LP

(Last) (First) (Middle)
1401 MCKINNEY STREET, SUITE 2400

(Street)
HOUSTON TX 77010

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director 10% Owner
Officer (give title below) X Other (specify below)
Fund Entity
1. Name and Address of Reporting Person*
Quantum Resources A1, LP

(Last) (First) (Middle)
1401 MCKINNEY STREET, SUITE 2400

(Street)
HOUSTON TX 77010

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director 10% Owner
Officer (give title below) X Other (specify below)
Fund Entity
1. Name and Address of Reporting Person*
Quantum Resources B, LP

(Last) (First) (Middle)
1401 MCKINNEY STREET, SUITE 2400

(Street)
HOUSTON TX 77010

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director 10% Owner
Officer (give title below) X Other (specify below)
Fund Entity
1. Name and Address of Reporting Person*
QAC Carried WI, LP

(Last) (First) (Middle)
1401 MCKINNEY STREET, SUITE 2400

(Street)
HOUSTON TX 77010

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director 10% Owner
Officer (give title below) X Other (specify below)
Fund Entity
1. Name and Address of Reporting Person*
Black Diamond Resources, LLC

(Last) (First) (Middle)
1401 MCKINNEY STREET, SUITE 2400

(Street)
HOUSTON TX 77010

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director 10% Owner
Officer (give title below) X Other (specify below)
Fund Entity
1. Name and Address of Reporting Person*
Quantum Resources C, LP

(Last) (First) (Middle)
1401 MCKINNEY STREET, SUITE 2400

(Street)
HOUSTON TX 77010

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director 10% Owner
Officer (give title below) X Other (specify below)
Fund Entity
Explanation of Responses:
1. Represents an aggregate of 7,145,866 subordinated units that were held (i) directly by Quantum Resources A1, LP, Quantum Resources B, LP, QAC Carried WI, LP, Black Diamond Resources, LLC, Quantum Resources C, LP, QAB Carried WI, LP and (ii) indirectly by QA Global GP, LLC, Black Diamond Resources 2, LLC, The Quantum Aspect Partnership, LP, QA GP, LLC and QA Holdings, LP.
2. Each subordinated unit converted to one common unit at the expiration of the subordination period, which occurred on December 22, 2012.
Remarks:
Form 1 of 2
/s/ Gregory S. Roden on behalf of QA Global GP, LLC et al. 08/02/2013
** 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 4 (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).
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