0001437749-21-014731.txt : 20210614 0001437749-21-014731.hdr.sgml : 20210614 20210614162523 ACCESSION NUMBER: 0001437749-21-014731 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210611 FILED AS OF DATE: 20210614 DATE AS OF CHANGE: 20210614 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gustin Michael H. CENTRAL INDEX KEY: 0001821852 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39464 FILM NUMBER: 211014883 MAIL ADDRESS: STREET 1: 208 HEWITT DRIVE STREET 2: #103-113 CITY: WOODWAY STATE: TX ZIP: 76712 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HighPeak Energy, Inc. CENTRAL INDEX KEY: 0001792849 STANDARD INDUSTRIAL CLASSIFICATION: DRILLING OIL & GAS WELLS [1381] IRS NUMBER: 843533602 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 421 W. 3RD STREET STREET 2: SUITE 1000 CITY: FORT WORTH STATE: TX ZIP: 76102 BUSINESS PHONE: (817) 850-9200 MAIL ADDRESS: STREET 1: 421 W. 3RD STREET STREET 2: SUITE 1000 CITY: FORT WORTH STATE: TX ZIP: 76102 4 1 rdgdoc.xml FORM 4 X0306 4 2021-06-11 0001792849 HighPeak Energy, Inc. HPK 0001821852 Gustin Michael H. 421 W. 3RD STREET, SUITE 1000 FORT WORTH TX 76102 1 Common Stock, par value $0.0001 per share 2021-06-11 5 G 0 12414 0 D 0 D Common Stock, par value $0.0001 per share 26914 I See Footnote On June 11, 2021, the Reporting Person transferred 12,414 shares of restricted common stock of the Issuer to a family trust of which the Reporting Person and the Reporting Person's wife are trustees. The Reporting Person and members of his immediate family are the sole beneficiaries of the trust. Shares held by Reporting Person's family trust. /s/ Steven W. Tholen as Attorney in Fact for Michael H. Gustin 2021-06-14