0000899243-21-003117.txt : 20210122
0000899243-21-003117.hdr.sgml : 20210122
20210122213714
ACCESSION NUMBER: 0000899243-21-003117
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200801
FILED AS OF DATE: 20210122
DATE AS OF CHANGE: 20210122
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: DuBard Denise
CENTRAL INDEX KEY: 0001353117
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35512
FILM NUMBER: 21547696
MAIL ADDRESS:
STREET 1: 717 TEXAS SUITE 2800
CITY: HOUSTON
STATE: TX
ZIP: 77002
FORMER NAME:
FORMER CONFORMED NAME: Bednorz Denise DuBard
DATE OF NAME CHANGE: 20060213
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
doc4.xml
FORM 4 SUBMISSION
X0306
4
2020-08-01
0
0001533924
Amplify Energy Corp.
AMPY
0001353117
DuBard Denise
C/O AMPLIFY ENERGY CORP.
500 DALLAS STREET, SUITE 1700
HOUSTON
TX
77002
0
1
0
0
SEE REMARKS
Common Stock, par value $0.01 per share
2020-08-01
4
M
0
2941
A
13284
D
As previously reported on 8/6/2019 by the reporting person, these restricted stock units with service-based vesting conditions ("TSUs") were originally granted under the Legacy Amplify Management Incentive Plan (the "MIP Plan") and vest periodically so long as the reporting person remains employed by Amplify Energy Corp. or one of its affiliates on each applicable vesting date. Amount reported represents the amount of such TSUs held by the reporting person that have vested to date. The TSUs convert into common stock on a one-for-one basis.
VICE PRESIDENT & CHIEF ACCOUNTING OFFICER
/s/ Eric M. Willis, Attorney-in-Fact
2021-01-22