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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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 control number. | SEC 1474 (9-02) |
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 Underlying Securities (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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
KEMP JOHN RANDOLPH III C/O KOSMOS ENERGY, LLC 8176 PARK LANE, SUITE 500 DALLAS, TX 75231 |
X |
/s/ Phillip Feiner, as Attorney-in-Fact | 01/15/2014 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | The amount of securities reported as directly beneficially owned in Column 5 reflects an adjustment to the number of such directly held common shares previously reported by the reporting person. The reporting person previously reported the following sales as being sales of such directly held common shares: 3,100 shares on December 3, 2013 and 1,389 shares on January 9, 2014 pursuant to a Rule 10b5-1 plan adopted by the reporting person. In fact, such sales were of common shares held indirectly by the John R. Kemp, III 2011 Grantor Retained Annuity Trust pursuant to a Rule 10b5-1 plan adopted by the reporting person. |
(2) | The amount of securities reported as indirectly beneficially owned in Column 5 reflects an adjustment in such common shares held by the reporting person's wife previously reported by the reporting person. The reporting person previously reported the sale of 1,389 common shares on January 9, 2014 as being a sale of shares held by the reporting person's wife pursuant to a Rule 10b5-1 plan adopted by the reporting person's wife. In fact, such sales were of common shares held indirectly by the Rosalind I. Kemp 2011 Grantor Retained Annuity Trust and sold pursuant to a Rule 10b5-1 plan adopted by the reporting person's wife. |
(3) | These shares are owned by the reporting person's wife. The reporting person disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein. |
(4) | The sales reported in this Form 4 were affected pursuant to a Rule 10b5-1 trading plan adopted by the reporting person. |
(5) | These shares granted under the Issuer's Long Term Incentive Plan are directly owned by the Rhonda N. Kemp 2011 Trust No. 1, Rhonda N. Kemp 2011 Trust No. 2, John R. Kemp, IV 2011 Trust No. 1, John R. Kemp, IV 2011 Trust No. 2, John R. Kemp, III 2011 Grantor Retained Annuity Trust and the Rosalind I. Kemp 2011 Grantor Retained Annuity Trust in the amount of 26,579, 26,579, 26,579, 26,579, 271,261 and 276,861 common shares, respectively. The reporting person disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein. |
(6) | The sales reported in this Form 4 were affected pursuant to a Rule 10b5-1 trading plan adopted by the reporting person's wife. |
(7) | These shares granted under the Issuer's Long Term Incentive Plan are directly owned by the Rhonda N. Kemp 2011 Trust No. 1, Rhonda N. Kemp 2011 Trust No. 2, John R. Kemp, IV 2011 Trust No. 1, John R. Kemp, IV 2011 Trust No. 2, John R. Kemp, III 2011 Grantor Retained Annuity Trust and the Rosalind I. Kemp 2011 Grantor Retained Annuity Trust in the amount of 26,579, 26,579, 26,579, 26,579, 271,261 and 274,361 common shares, respectively. The reporting person disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein. |