-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, PgnOgKht7AdTFPjqdCoNztj3Tk7tKfBdU5bH0qAmnixlHdeY7KmQmVHlMQP5rw0c +UMajBxJOMT3pn1//ZLkJw== 0001373607-10-000002.txt : 20100709 0001373607-10-000002.hdr.sgml : 20100709 20100709145223 ACCESSION NUMBER: 0001373607-10-000002 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20100709 FILED AS OF DATE: 20100709 DATE AS OF CHANGE: 20100709 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hackett Montague H Jr CENTRAL INDEX KEY: 0001373607 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-16653 FILM NUMBER: 10946138 MAIL ADDRESS: STREET 1: 550 PARK AVENUE CITY: NEW YORK STATE: NY ZIP: 10065 FORMER NAME: FORMER CONFORMED NAME: Hackett Montague H DATE OF NAME CHANGE: 20060822 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: EMPIRE PETROLEUM CORP CENTRAL INDEX KEY: 0000887396 STANDARD INDUSTRIAL CLASSIFICATION: CRUDE PETROLEUM & NATURAL GAS [1311] IRS NUMBER: 731238709 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 8801 S YALE STREET 2: SUITE 120 CITY: TULSA STATE: OK ZIP: 74137-3575 BUSINESS PHONE: 918-488-8068 MAIL ADDRESS: STREET 1: 8801 S YALE STREET 2: SUITE 120 CITY: TULSA STATE: OK ZIP: 74137-3575 FORMER COMPANY: FORMER CONFORMED NAME: AMERICOMM RESOURCES CORP DATE OF NAME CHANGE: 19951115 FORMER COMPANY: FORMER CONFORMED NAME: AMERICOMM CORP DATE OF NAME CHANGE: 19930328 4 1 primary_doc.xml PRIMARY DOCUMENT X0303 4 2010-07-09 0 0000887396 EMPIRE PETROLEUM CORP EMPR 0001373607 Hackett Montague H Jr 550 PARK AVENUE NEW YORK NY 10065 1 0 1 0 COMMON STOCK 2010-07-09 4 P 0 277778 0.09 A 9565288 D COMMON STOCK 607143 I BY WIFE COMMON STOCK 2010-07-09 4 P 0 277778 0.09 A 2206350 I BY TRUST COMMON STOCK 2010-07-09 4 P 0 277778 0.09 A 1945635 I BY TRUST Common Stock Warrant(right to buy) 0.5 2010-07-09 4 P 0 138889 0 A 2010-07-03 2011-07-02 COMMON STOCK 138889 451389 D Common Stock Warrants(right to buy) 0.5 2010-07-09 4 P 0 138889 0 A 2010-07-03 2011-07-02 COMMON STOCK 138889 263889 I BY TRUST Common Stock Warrants(right to buy) 0.5 2010-07-09 4 P 0 138889 0 A 2010-07-03 2011-07-02 COMMON STOCK 138889 263889 I BY TRUST MAYME M HACKETT IS THE REPORTING PERSON'S WIFE. THE REPORTING PERSON DISCLAIMS OWNERSHIP OF THESE SHARES AND THIS REPORT SHOULD NOT BE DEEMED AN ADMISSION THAT THE REPORTING PERSON IS THE BENEFICIAL OWNER OF THESE SHARES FOR PURPOSES OF SECTION 16 OR ANY OTHER PURPOSES. THE REPORTING PERSON IS THE TRUSTEE OF THE TRUST F/B/O MELINDA HACKETT WHICH IS THE REPORTING PERSON'S DAUGHTER. THE REPORTING PERSON DISCLAIMS OWNERSHIP OF THESE SHARES AND THIS REPORT SHOULD NOT BE DEEMED AN ADMISSION THAT THE REPORTING PERSON IS THE BENEFICIAL OWNER OF THESE SHARES FOR PURPOSES OF SECTION 16 OR ANY OTHER PURPOSES. THE REPORTING PERSON IS THE TRUSTEE FOR THE TRUST F/B/O MONTAGUE H. HACKETT, III WHICH IS THE REPORTING PERSON'S SON. THE REPORTING PERSON DISCLAIMS OWNERSHIP OF THESE SHARES AND THIS REPORT SHOULD NOT BE DEEMED AN ADMISSION THAT THE REPORTING PERSON IS THE BENEFICIAL OWNER OF THESE SHARES FOR PURPOSES OF SECTION 16 OR FOR ANY OTHER PURPOSES. THE REPORTING PERSON IS THE TRUSTEE OF THE TRUST F/B/O MELINDA HACKETT WHICH IS THE REPORTING PERSON'S DAUGHTER. THE REPORTING PERSON DISCLAIMS OWNERSHIP OF THESE WARRANT SHARES AND THIS REPORT SHOULD NOT BE DEEMED AN ADMISSION THAT THE REPORTING PERSON IS THE BENEFICIAL OWNER OF THESE WARRANT SHARES FOR PURPOSES OF SECTION 16 OR ANY OTHER PURPOSES. THE REPORTING PERSON IS THE TRUSTEE FOR THE TRUST F/B/O MONTAGUE H. HACKETT, III WHICH IS THE REPORTING PERSON'S SON. THE REPORTING PERSON DISCLAIMS OWNERSHIP OF THESE WARRANT SHARES AND THIS REPORT SHOULD NOT BE DEEMED AN ADMISSION THAT THE REPORTING PERSON IS THE BENEFICIAL OWNER OF THESE WARRANT SHARES FOR PURPOSES OF SECTION 16 OR FOR ANY OTHER PURPOSES. MONTAGUE H. HACKETT, JR 2010-07-09 -----END PRIVACY-ENHANCED MESSAGE-----