0001104659-12-085074.txt : 20121219 0001104659-12-085074.hdr.sgml : 20121219 20121219060120 ACCESSION NUMBER: 0001104659-12-085074 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20121217 FILED AS OF DATE: 20121219 DATE AS OF CHANGE: 20121219 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Mazzanti Daryl V CENTRAL INDEX KEY: 0001332799 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32942 FILM NUMBER: 121273041 MAIL ADDRESS: STREET 1: 10600 NORTH DE ANZA BLVD., SUITE 250 CITY: CUPERTINO STATE: CA ZIP: 95014 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: EVOLUTION PETROLEUM CORP CENTRAL INDEX KEY: 0001006655 STANDARD INDUSTRIAL CLASSIFICATION: CRUDE PETROLEUM & NATURAL GAS [1311] IRS NUMBER: 411781991 STATE OF INCORPORATION: NV FISCAL YEAR END: 0630 BUSINESS ADDRESS: STREET 1: 2500 CITYWEST BLVD STREET 2: SUITE 1300 CITY: HOUSTON STATE: TX ZIP: 77042 BUSINESS PHONE: 713-935-0122 MAIL ADDRESS: STREET 1: 2500 CITYWEST BLVD STREET 2: SUITE 1300 CITY: HOUSTON STATE: TX ZIP: 77042 FORMER COMPANY: FORMER CONFORMED NAME: NATURAL GAS SYSTEMS INC/NEW DATE OF NAME CHANGE: 20040817 FORMER COMPANY: FORMER CONFORMED NAME: NATURAL GAS SYSTEMS, INC. DATE OF NAME CHANGE: 20040810 FORMER COMPANY: FORMER CONFORMED NAME: REALITY INTERACTIVE INC DATE OF NAME CHANGE: 19960301 4 1 a4.xml 4 X0306 4 2012-12-17 0 0001006655 EVOLUTION PETROLEUM CORP EPM 0001332799 Mazzanti Daryl V 2500 CITY WEST BLVD. SUITE 1300 HOUSTON TX 77042 0 1 0 0 VP Operations COMMON STOCK 2012-12-17 4 P 0 2800 7.80 A 191983 D /s/ Daryl Mazzanti 2012-12-18