SEC FORM 3 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*
MCCARTHY TIMOTHY P

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

(Street)
COVINGTON LA 70433

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
03/25/2004
3. Issuer Name and Ticker or Trading Symbol
HORNBECK OFFSHORE SERVICES INC /LA [ HOS ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Controller
5. 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 Beneficially Owned
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)
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
Stock Options (right to buy) 05/28/2003(1) 05/28/2012 Common Stock 8,000 6.63 D
Stock Options (right to buy) 03/13/2004(2) 03/13/2013 Common Stock 3,600 11.2 D
Common Stock 02/17/2005(3) 02/17/2014 Common Stock 6,000 13.83 D
Explanation of Responses:
1. The option provides for vesting in four equal annual installments commencing on 05/28/2003.
2. The option provides for vesting in three equal annual installments commencing on 03/13/2004.
3. The option provides for vesting in three equal annual installments commencing on 02/17/2005.
Remarks:
This form gives effect to a 1-to-2.5 reverse stock split effected March 5, 2004.
/s/ Timothy P. McCarthy 03/25/2004
** 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.
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