0001104659-19-044650.txt : 20190807
0001104659-19-044650.hdr.sgml : 20190807
20190807212743
ACCESSION NUMBER: 0001104659-19-044650
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190806
FILED AS OF DATE: 20190807
DATE AS OF CHANGE: 20190807
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Carr Alan Jeffrey
CENTRAL INDEX KEY: 0001623467
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35512
FILM NUMBER: 191007252
MAIL ADDRESS:
STREET 1: 8540 GANDER CREEK DRIVE
CITY: MIAMISBURG
STATE: OH
ZIP: 45342
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Amplify Energy Corp.
CENTRAL INDEX KEY: 0001533924
STANDARD INDUSTRIAL CLASSIFICATION: CRUDE PETROLEUM & NATURAL GAS [1311]
IRS NUMBER: 821326219
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 500 DALLAS STREET
STREET 2: SUITE 1700
CITY: HOUSTON
STATE: TX
ZIP: 77002
BUSINESS PHONE: 713-588-8369
MAIL ADDRESS:
STREET 1: 500 DALLAS STREET
STREET 2: SUITE 1700
CITY: HOUSTON
STATE: TX
ZIP: 77002
FORMER COMPANY:
FORMER CONFORMED NAME: Midstates Petroleum Company, Inc.
DATE OF NAME CHANGE: 20111031
4
1
a4.xml
4
X0306
4
2019-08-06
1
0001533924
Amplify Energy Corp.
AMPY
0001623467
Carr Alan Jeffrey
321 SOUTH BOSTON,
SUITE 1000
TULSA
OK
74103
1
0
0
0
Common Stock
2019-08-06
4
M
0
12716
0
A
12816
D
Common Stock
2019-08-06
4
M
0
52491
0
A
65307
D
Common Stock
2019-08-06
4
D
0
14013
10.00
D
51294
D
Performance Stock Units
2019-08-06
4
M
0
12716
0
D
Common Stock
12716
0
D
Restricted Stock Units
2019-08-06
4
M
0
52491
0
D
Common Stock
52491
0
D
Represents shares sold to the Issuer in connection with the previously announced Issuer tender offer.
Each performance stock unit represents a contingent right to receive one share of common stock of the Issuer.
Each restricted stock unit represents a contingent right to receive one share of common stock of the Issuer.
Pursuant to that certain Agreement and Plan of Merger, dated as of May 5, 2019, by and among the Issuer (formerly known as Midstates Petroleum Company, Inc.), Amplify Energy Corp. ("Legacy Amplify") and Midstates Holdings, Inc., a direct wholly owned subsidiary of the Issuer ("Merger Sub"), on August 6, 2019, Merger Sub merged with and into Legacy Amplify, with Legacy Amplify surviving the merger as a wholly owned subsidiary of the Issuer, and immediately thereafter, as part of the same transaction, Legacy Amplify merged with and into a wholly owned subsidiary of the Issuer, with such subsidiary continuing as the surviving entity (the "Merger"). At the closing of the Merger, each outstanding restricted stock unit and performance stock unit award held by the Reporting Person immediately became fully vested and was settled in shares of the Issuer's common stock.
/s/ Alan Jeffrey Carr, by Scott C. Weatherholt, as Attorney-in-Fact
2019-08-07