Sec Form 3 Filing - Hollis Michael L. @ HighPeak Energy, Inc. - 2020-08-21

Insider filing report for Changes in Beneficial Ownership
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FORM 3
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
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, 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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1. Name and Address of Reporting Person
Hollis Michael L.
2. Issuer Name and Ticker or Trading Symbol
HighPeak Energy, Inc. [ HPK]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
President
(Last) (First) (Middle)
421 W. 3RD STREET, SUITE 1000
3. Date of Earliest Transaction (MM/DD/YY)
08/21/2020
(Street)
FORT WORTH, TX76102
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 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, par value $0.0001 per share 26,802 D ( 1 ) ( 2 )
Common Stock, par value $0.0001 per share 100 I See Footnotes ( 3 )
Common Stock, par value $0.0001 per share 100 I See Footnotes ( 3 )
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 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
(MM/DD/YY)
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)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Warrants $ 11.5 09/20/2020 08/21/2025 Common Stock, par value $0.0001 per share 30,382 ( 4 ) D
Warrants $ 11.5 09/20/2020 08/21/2025 Common Stock, par value $0.0001 per share 100 ( 5 ) I See Footnote ( 5 )
Warrants $ 11.5 09/20/2020 08/21/2025 Common Stock, par value $0.0001 per share 100 ( 5 ) I See Footnote ( 5 )
Contingent Value Rights ( 6 ) ( 6 ) ( 6 ) Common Stock, par value $0.0001 per share 56,954 ( 6 ) D
Contingent Value Rights ( 6 ) ( 6 ) ( 6 ) Common Stock, par value $0.0001 per share 212 ( 6 ) I See Footnote ( 7 )
Contingent Value Rights ( 6 ) ( 6 ) ( 6 ) Common Stock, par value $0.0001 per share 212 ( 6 ) I See Footnote ( 7 )
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Hollis Michael L.
421 W. 3RD STREET, SUITE 1000
FORT WORTH, TX76102
X President
Signatures
/s/ Steven W. Tholen, Attorney-in-Fact 08/26/2020
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Includes 16,802 shares of common stock, par value $0.0001 per share ("Common Stock") of HighPeak Energy, Inc., a Delaware corporation (the "Issuer") received by the Reporting Person in exchange for an equivalent number of shares of Class A common stock, par value $0.0001 per share ("Class A Common Stock") of Pure Acquisition Corp. ("Pure") in connection with the closing of a business combination transaction (the "Transaction") between the Issuer and Pure on August 21, 2020.
( 2 )In connection with the Transaction, the Reporting Person was issued 10,000 shares of Common Stock, 10,000 warrants of the Issuer representing the right to purchase Common Stock and 10,000 contingent value rights ("CVRs") of the Issuer, pursuant to the Amended & Restated Forward Purchase Agreement, dated July 24, 2020 (the "Forward Purchase Agreement"), by and among (i) the Issuer, (ii) the Purchasers (as defined therein) designated as parties thereto, (iii) HighPeak Energy Partners, LP and (iv) solely for the limited purposes specified therein, Pure.
( 3 )Represents shares of Common Stock issued to the Reporting Person's son in exchange for shares of Class A Common Stock in connection with the Transaction.
( 4 )Represents warrants to purchase Common Stock of the Issuer issued to the Reporting Person (i) pursuant to the Forward Purchase Agreement, (ii) in exchange for Class A Common Stock in connection with the Transaction and (iii) in exchange for Pure's warrants in connection with the Transaction.
( 5 )Represents warrants to purchase Common Stock issued to the Reporting Person's son in exchange for Class A Common Stock in connection with the Transaction.
( 6 )Pursuant to the Contingent Value Rights Agreement, dated August 21, 2020 (the "CVR Agreement"), by and among (i) the Issuer, (ii) HighPeak Energy, LP, (iii) HighPeak Energy II, LP, (iv) HighPeak Pure Acquisition, LLC and (v) Continental Stock Transfer & Trust Company, as rights agent, entered into in connection with the Transaction, each CVR entitles Qualifying CVR Holders (as defined in the CVR Agreement) to receive, in certain circumstances, additional shares of Common Stock (or, in limited circumstances, such other form as is provided for in the CVR Agreement), if necessary, to satisfy a 10% preferred simple annual return (based on a $10.00 per share price at the closing of the Transaction), subject to a floor downside per-share price of $4.00, for certain qualifying holders as of the CVR Maturity Date (as defined in the CVR Agreement).
( 7 )Represents CVRs issued to the Reporting Person in exchange for shares of Class A Common Stock in connection with the Transaction.

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