SEC Form 4
FORM 4 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
| 2. Issuer Name and Ticker or Trading Symbol Creek Road Miners, Inc. [ CRKR ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
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3. Date of Earliest Transaction (Month/Day/Year) 03/30/2022 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed (Month/Day/Year) | 6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common Stock | 03/31/2022 | S | 7,000 | D | $2.7119 | 1,202,523 | D | |||
Common Stock | 03/31/2022 | S | 11,000 | D | $2.6333 | 1,202,523 | D |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Series A Preferred Stock | $0 | 03/30/2022 | M | 6,249 | 09/30/2021 | (1) | Common Stock | 357,085 | (1) | 6,250 | D | ||||
Convertible Debenture | $0.175 | 03/30/2022 | C | $1,925 | 12/19/2019 | 12/31/2022 | Common Stock | 11,000 | (2) | $2,496,850 | I | See Footnote 3.(3) | |||
Convertible Debenture | $0.175 | 03/31/2022 | C | $1,225 | 12/19/2019 | 12/31/2022 | Common Stock | 7,000 | (2) | $2,496,850 | I | See Footnote 3.(3) | |||
Series A Preferred Stock | (1) | 12/31/2021 | (1) | Common Stock | 357,142 | 6,250 | D | ||||||||
Options | $2.65 | 12/01/2021 | (4) | Common Stock | 2,625,000 | 2,625,000 | D | ||||||||
Options | $0.25 | 08/03/2020 | 08/03/2025 | Common Stock | 37,500 | 37,500 | D | ||||||||
Convertible Debenture | $0.175 | 12/19/2019 | 12/31/2022 | Common Stock | 14,267,714 | $2,496,850 | I | See Footnote 3.(3) | |||||||
Warrant | $0.175 | 12/19/2019 | 12/01/2024 | Common Stock | 4,285,174 | 4,285,174 | I | See Footnote 3.(3) |
Explanation of Responses: |
1. Each share of Series A Preferred Stock (the "Preferred Stock") is convertible into a number of shares of common stock determined by dividing the stated value of each share of Preferred Stock (currently $10) by the conversion price then in effect (currently $0.175). The Preferred Stock does not expire. |
2. The dollar face amount of the Debenture is convertible into shares of common stock at the conversion price then in effect (currently $0.175). |
3. Securities held by Barlock 2019 Fund, LP, an entity over which Scott Kaufman has managerial control. |
4. Options granted pursuant to incentive and award plans. 25% of the options vest when the common share VWAP computed over 30 trading days reaches $2.50, $3.00, $3.50 and $4.00. |
/s/ Scott D. Kaufman | 04/01/2022 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |