-----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, J7jcmZzikOYejzZUWHEqrb+Gyu0bIW5Q0J/I0CycBMJ/UQrNL2Egj14WSLErpgR5 7K9e4n119T9qeVEZNjlJKQ== 0001209191-03-012213.txt : 20030717 0001209191-03-012213.hdr.sgml : 20030717 20030717100649 ACCESSION NUMBER: 0001209191-03-012213 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030716 FILED AS OF DATE: 20030717 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PETROQUEST ENERGY INC CENTRAL INDEX KEY: 0000872248 STANDARD INDUSTRIAL CLASSIFICATION: CRUDE PETROLEUM & NATURAL GAS [1311] IRS NUMBER: 721440714 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 400 E KALISTE SALOOM RD SUITE 6000 CITY: LAFAYETTE STATE: LA ZIP: 70508 BUSINESS PHONE: 3372327028 MAIL ADDRESS: STREET 1: 400 E KALISTE SALOOM RD SUITE 6000 CITY: LAFAYETTE STATE: LA ZIP: 70508 FORMER COMPANY: FORMER CONFORMED NAME: OPTIMA PETROLEUM CORP DATE OF NAME CHANGE: 19950726 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: NORDBERG E WAYNE CENTRAL INDEX KEY: 0001111624 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19020 FILM NUMBER: 03790437 BUSINESS ADDRESS: STREET 1: 2 WORLD TRADE CENTER 85TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10048 BUSINESS PHONE: 2124324506 MAIL ADDRESS: STREET 1: 2 WORLD TRDE CENTER 85TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10048 4 1 boh07495_boh1ewn.xml MAIN DOCUMENT DESCRIPTION X0101 42003-07-1600000872248PETROQUEST ENERGY INC PQUE0001111624NORDBERG E WAYNE 1000Common Stock2003-07-164X0500001.25A345000DCommon Stock2003-07-164X0100001.25A82160IBy wifeCommon Stock2003-07-164X0250001.25A 135000IBy Anna & Samuel Nordberg TrustCommon Stock2003-07-164J000A120000 IBy Olivia S. Nordberg TrustCommon Stock2003-07-164J000A20000IBy Hollow Brook Associates, LLC Deferred Benefit Pension PlanCommon Stock Warrant (right to buy)1.252003-07-164X0500000D1999-08-032003-08-02Common Stock500000DCommon Stock Warrant (right to buy)1.252003-07-164X0100000D1999-08-032003-08-02Common Stock100000IBy wifeCommon Stock Warrant (right to buy)1.252003-07-164X025000< /value>0D1999-08-032003-08-02Common Stock250000IBy Anna & Samuel Nordberg Trust160 of these shares are held in a custodial account (of which Janet Mavec is the custodian) for the benefit of Akasha Mavec/s/ E. Wayne Nordberg2003-07-16 -----END PRIVACY-ENHANCED MESSAGE-----