SEC FORM 4

SEC Form 4

FORM 4

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

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).

1. Name and Address of Reporting Person^*

CYPRESS ENERGY HOLDINGS, LLC

(Last)

(First)

(Middle)

5727 S. LEWIS AVENUE, SUITE 500

(Street)

TULSA

74105

(City)

(State)

(Zip)

2. Issuer Name and Ticker or Trading Symbol
Cypress Energy Partners, L.P. [ CELP ]

5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	X	10% Owner
	Officer (give title below)	X	Other (specify below)
			REFER TO FOOTNOTES 1 AND 2.

3. Date of Earliest Transaction (Month/Day/Year)
01/21/2014

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 Following Reported Transaction(s) (Instr. 3 and 4)	6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	Code	V	Amount	(A) or (D)	Price		6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
Common Units (Limited Partner Interests)	01/21/2014		A		671,250⁽¹⁾⁽²⁾⁽³⁾	A	⁽⁴⁾	671,250⁽¹⁾⁽²⁾⁽³⁾	I⁽²⁾	By Cypress Energy Holdings II, LLC
Common Units (Limited Partner Interests)	01/21/2014		A		673,400⁽¹⁾⁽²⁾⁽⁴⁾	A	⁽⁵⁾	673,400⁽¹⁾⁽²⁾⁽⁴⁾	I⁽²⁾	By Cypress Energy Partners - TIR, LLC

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)
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)	Code	V	(A)	(D)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	8. Price of Derivative Security (Instr. 5)		10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
Subordinated Units (Limited Partner Interests)	⁽⁶⁾	01/21/2014		A		4,983,750⁽¹⁾⁽²⁾⁽³⁾		⁽⁶⁾	⁽⁶⁾	Common Units (Limited Partner Interests)	4,983,750⁽¹⁾⁽²⁾⁽³⁾	$0⁽³⁾	4,983,750⁽¹⁾⁽²⁾⁽⁴⁾	I⁽²⁾	By Cypress Energy Holdings II, LLC
Subordinated Units (Limited Partner Interests)	⁽⁶⁾	01/21/2014		J⁽⁴⁾			44,451	⁽⁶⁾	⁽⁶⁾	Common Units (Limited Partner Interests)	44,451	$0⁽⁴⁾	4,939,299⁽¹⁾⁽²⁾⁽⁴⁾	I⁽²⁾	By Cypress Energy Holdings II, LLC
Subordinated Units (Limited Partner Interests)	⁽⁶⁾	01/21/2014		A		673,400⁽¹⁾⁽²⁾⁽⁵⁾		⁽⁶⁾	⁽⁶⁾	Common Units (Limited Partner Interests)	673,400⁽¹⁾⁽²⁾⁽⁵⁾	$0⁽⁵⁾	673,400⁽¹⁾⁽²⁾⁽⁵⁾	I⁽²⁾	By Cypress Energy Partners - TIR, LLC

1. Name and Address of Reporting Person^*

CYPRESS ENERGY HOLDINGS, LLC

(Last)

(First)

(Middle)

5727 S. LEWIS AVENUE, SUITE 500

(Street)

TULSA

74105

(City)

(State)

(Zip)

Relationship of Reporting Person(s) to Issuer

X	Director	X	10% Owner
	Officer (give title below)	X	Other (specify below)
			REFER TO FOOTNOTES 1 AND 2.

1. Name and Address of Reporting Person^*

CYPRESS ENERGY HOLDINGS II, LLC

(Last)

(First)

(Middle)

5727 S. LEWIS AVENUE, SUITE 500

(Street)

TULSA

74105

(City)

(State)

(Zip)

Relationship of Reporting Person(s) to Issuer

X	Director	X	10% Owner
	Officer (give title below)	X	Other (specify below)
			REFER TO FOOTNOTES 1 AND 2.

1. Name and Address of Reporting Person^*

CYPRESS ENERGY PARTNERS - TIR, LLC

(Last)

(First)

(Middle)

5727 S. LEWIS AVENUE, SUITE 500

(Street)

TULSA

74105

(City)

(State)

(Zip)

Relationship of Reporting Person(s) to Issuer

X	Director	X	10% Owner
	Officer (give title below)	X	Other (specify below)
			REFER TO FOOTNOTES 1 AND 2.

1. Name and Address of Reporting Person^*

CYPRESS ENERGY INVESTMENTS, LLC

(Last)

(First)

(Middle)

5727 S. LEWIS AVENUE, SUITE 500

(Street)

TULSA

74105

(City)

(State)

(Zip)

Relationship of Reporting Person(s) to Issuer

X	Director	X	10% Owner
	Officer (give title below)	X	Other (specify below)
			REFER TO FOOTNOTES 1 AND 2.

1. Name and Address of Reporting Person^*

CYPRESS ENERGY PARTNERS GP, LLC

(Last)

(First)

(Middle)

5727 S. LEWIS AVENUE, SUITE 500

(Street)

TULSA

74105

(City)

(State)

(Zip)

Relationship of Reporting Person(s) to Issuer

X	Director		10% Owner
	Officer (give title below)	X	Other (specify below)
			REFER TO FOOTNOTES 1 AND 2.

Explanation of Responses:

1. In connection with the closing (the "Closing") of the Issuer's initial public offering and the related Closing transactions as reported in the Issuer's Registration Statement on Form S-1 (Registration No. 333 192328) (the "Registration Statement"), this Form 4 is filed jointly by Cypress Energy Holdings, LLC ("Cypress Holdings"), Cypress Energy Holdings II, LLC ("Holdings II"), a wholly owned subsidiary of Cypress Holdings, Cypress Energy Partners GP, LLC (the "General Partner"), a wholly owned subsidiary of Holdings II and the general partner of the Issuer, Cypress Energy Investments, LLC ("Energy Investments") which is a subsidiary of Cypress Holdings, and Cypress Energy Partners - TIR, LLC ("CEP TIR"), a wholly owned subsidiary of Energy Investments.

2. Cypress Holdings may be deemed to own the securities of the Issuer held by Holdings II, but disclaims beneficial ownership except to the extent of its pecuniary interest therein. Cypress Holdings and Energy Investments may be deemed to own the securities of the Issuer held by CEP TIR, but each disclaims beneficial ownership except to the extent of its pecuniary interest therein.

3. Pursuant to a Contribution, Conveyance and Assumption Agreement by and among the Issuer, Cypress Holdings, Holdings II, CEP TIR, the General Partner and the other parties thereto (the "Contribution Agreement"), effective as of the Closing, Holdings II holds (i) 671,250 common units of the Issuer (after the exercise of 562,500 common units by the underwriters in connection with the over-allotment option for the Issuer's initial public offering) and (ii) 4,983,750 subordinated units of the Issuer.

4. Pursuant to the Contribution Agreement, effective as of the Closing, Holdings II transferred 44,451 subordinated units to certain other parties to the Contribution Agreement in connection with the conversion of membership interests in Cypress Holdings to subordinated units of the Issuer.

5. Pursuant to the Contribution Agreement, effective as of the Closing, CEP TIR holds (i) 673,400 common units of the Issuer and (ii) 673,400 subordinated units of the Issuer.

6. Each subordinated unit will convert into one common unit at the end of the subordination period described in the Registration Statement.

	/s/ G. Les Austin, Chief Financial Officer of Cypress Energy Holdings, LLC	01/23/2014
	/s/ G. Les Austin, Chief Financial Officer, Vice President, Secretary and Treasurer of Cypress Energy Holdings II, LLC	01/23/2014
	/s/ G. Les Austin, Chief Financial Officer, Vice President, Secretary and Treasurer of Cypress Energy Partners - TIR, LLC	01/23/2014
	/s/ G. Les Austin, Chief Financial Officer, Vice President, Secretary and Treasurer of Cypress Energy Investments, LLC	01/23/2014
	/s/ G. Les Austin, Vice President and Chief Financial Officer of Cypress Energy Partners GP, LLC	01/23/2014
	** Signature of Reporting Person	Date
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