0001437749-23-020447.txt : 20230721
0001437749-23-020447.hdr.sgml : 20230721
20230721162433
ACCESSION NUMBER: 0001437749-23-020447
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230719
FILED AS OF DATE: 20230721
DATE AS OF CHANGE: 20230721
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Forbes Keith E
CENTRAL INDEX KEY: 0001831867
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39464
FILM NUMBER: 231102773
MAIL ADDRESS:
STREET 1: 421 W. 3RD STREET
STREET 2: SUITE 1000
CITY: FORT WORTH
STATE: TX
ZIP: 76102
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
X0508
4
2023-07-19
0001792849
HighPeak Energy, Inc.
HPK
0001831867
Forbes Keith E
421 W. 3RD STREET, SUITE 1000
FORT WORTH
TX
76102
1
Vice President and Controller
0
Common Stock, par value $0.0001 per share
2023-07-19
4
P
0
14000
10.50
A
14000
I
See Footnote 2
Common Stock, par value $0.0001 per share
250
I
By Wife
Employee Stock Option (right to buy)
10.50
2023-07-21
4
A
0
15000
0
A
2026-10-31
Common Stock, par value $0.0001 per share
15000
15000
D
Represents shares of HighPeak Energy, Inc. (the "Issuer") common stock, par value $0.0001 per share ("Common Stock") purchased by the Reporting Person's personal investment vehicle from Roth Capital Partners, LLC (the "Underwriter") in an underwritten public offering conducted by the Issuer pursuant to an Underwriting Agreement between the Issuer and the Underwriter.
The stock option was designed to comply with the requirements of Section 409A of the Internal Revenue Code of 1986, as amended, and the guidance thereunder, and is exercisable only during the 90 day period following the earlier to occur of the Reporting Person's separation from service due to death or disability, the occurrence of a change in control of the Issuer, or August 1, 2026.
/s/ Steven W. Tholen as Attorney in Fact for Keith E. Forbes
2023-07-21