SEC Form 3
FORM 3 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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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1. Name and Address of Reporting Person*
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year) 08/11/2016 | 3. Issuer Name and Ticker or Trading Symbol Mid-Con Energy Partners, LP [ MCEP ] | |||||||||||||
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| 5. 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 Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Class A Convertible Preferred Units | 02/11/2017 | 08/11/2021 | Common Units Representing Limited Partner Interests | 1,860,465(1) | 2.15 | I | By Goff REN Holdings, LLC(2) |
Class A Convertible Preferred Units | 02/11/2017 | 08/11/2021 | Common Units Representing Limited Partner Interests | 2,697,674(3) | 2.15 | I | By Goff MCEP Holdings, LLC(2) |
Class A Convertible Preferred Units | 02/11/2017 | 08/11/2021 | Common Units Representing Limited Partner Interests | 232,558(4) | 2.15 | I | By The Goff Family Foundation(2) |
1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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Explanation of Responses: |
1. These shares are held directly by Goff REN Holdings, LLC (Goff REN). John C. Goff is the president of Goff Capital, Inc., which is a member of Goff REN. Longboat Capital, LLC (Longboat) is a member of Goff REN. James M. Howard is the manager of Longboat and co-manager of Goff REN. Keith B. Ohnmeis is a co-manager of Goff REN and an employee of Goff Capital, Inc. Each of the foregoing, except Goff REN, disclaim beneficial ownership of these securities except to the extent of their respective pecuniary interest therein. |
2. Goff REN, Goff MCEP, the Foundation, John C. Goff, Goff Capital, Inc., Longboat, James M. Howard and Keith B. Ohnmeis may be considered a group under Section 13(d) of the Exchange Act; however, neither the fact of this filing nor anything contained herein shall be deemed to be an admission by such persons that such a group exists. |
3. These shares are held directly by Goff MCEP Holdings, LLC (Goff MCEP). John C. Goff is the president of Goff Capital, Inc., which is the manager of Goff MCEP. Each of the foregoing, except Goff MCEP, disclaim beneficial ownership of these securities except to the extent of their respective pecuniary interest therein. |
4. These shares are held directly by The Goff Family Foundation (the Foundation). John C. Goff is the sole board member of the Foundation. Mr. Goff disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein. |
/s/ John C. Goff | 08/17/2016 | |
Goff REN Holdings, LLC, By: /s/ Keith B. Ohnmeis, Manager and By: /s/ James M. Howard, Manager | 08/17/2016 | |
Goff MCEP Holdings, LLC, By: Goff Capital, Inc., Manager, By: /s/ John C. Goff, President | 08/17/2016 | |
Goff Capital, Inc., By: /s/ John C. Goff, President | 08/17/2016 | |
The Goff Family Foundation, By: /s/ John C. Goff, Sole Board Member | 08/17/2016 | |
Longboat Capital, LLC, By: /s/ James M. Howard, Manager | 08/17/2016 | |
/s/ James M. Howard | 08/17/2016 | |
/s/ Keith B. Ohnmeis | 08/17/2016 | |
** 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 5 (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. |