SEC FORM 4 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*
HORNBECK TODD M

(Last) (First) (Middle)
103 NORTHPARK BOULEVARD, SUITE 300

(Street)
COVINGTON LA 70433

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
HORNBECK OFFSHORE SERVICES INC /LA [ HOS ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
President & CEO
3. Date of Earliest Transaction (Month/Day/Year)
02/16/2018
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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 02/16/2018 M 47,339 A (1) 976,769 D
COMMON STOCK 02/16/2018 D 47,339 D $3.57(1) 929,430 D
COMMON STOCK 02/16/2018 F 13,918(2) D $3.73 915,512 D
COMMON STOCK 42,511(3) I By Limited Partnership
COMMON STOCK 1,650 I By Wife
COMMON STOCK 70,000(4) I By Family Trusts
COMMON STOCK 70 I By UTMA custodian for child
COMMON STOCK 220 I By IRA
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 (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
PHANTOM STOCK (1) 02/16/2018 M 47,339 (1) (1) COMMON STOCK 47,339 (1) 47,339 D
Explanation of Responses:
1. Represents the one-third vesting and cash settlement of a time-vest phantom restricted stock unit award with a Grant Date of February 16, 2016. Each phantom unit is the economic equivalent of one share of the Company's Common Stock. The phantom shares are payable in cash or stock at the election of the Company. Cash awards are based on a 10 day trailing average of the market price of the Company's stock on the vesting date. No shares were actually issued, converted, or sold in connection with this transaction.
2. Disposition of these shares represents payment of tax liability by delivering or withholding securities incident to the vesting of a restricted stock award issued in accordance with Rule 16b-3.
3. Represents shares beneficially owned by Reporting Person through a Family Limited Partnership
4. Represents shares beneficially owned by Reporting Person through various family trusts.
Remarks:
/s/ Beth A. LaBrosse as POA for Todd M. Hornbeck 02/21/2018
** 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).
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