Form 3 Crescent Energy Co For: Dec 07 Filed by: Brown Bevin
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF
Filed pursuant to Section 16(a) of the
Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act
||December 31, 2014
|Estimated average burden|
|hours per response:
1. Name and Address of Reporting Person
|600 TRAVIS STREET, SUITE 7200|
2. Date of Event Requiring Statement
3. Issuer Name
Ticker or Trading Symbol
Crescent Energy Co
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
||Officer (give title below)
||Other (specify below)
5. If Amendment, Date of Original Filed
6. Individual or Joint/Group Filing (Check
||Form filed by One Reporting Person
||Form filed by More than One Reporting
|Table I - Non-Derivative Securities Beneficially Owned|
|1. Title of Security (Instr.
Amount of Securities Beneficially Owned (Instr.
||3. Ownership Form: Direct (D) or Indirect (I) (Instr.
||4. Nature of Indirect Beneficial Ownership (Instr.
No securities beneficially owned.
Table II - Derivative Securities Beneficially Owned|
(e.g., puts, calls, warrants, options, convertible securities)
|1. Title of Derivative Security (Instr.
||2. Date Exercisable and Expiration Date
||3. Title and Amount of Securities Underlying Derivative Security (Instr.
||4. Conversion or Exercise Price of Derivative Security
||5. Ownership Form: Direct (D) or Indirect (I) (Instr.
||6. Nature of Indirect Beneficial Ownership (Instr.
||Amount or Number of Shares
|Explanation of Responses:|
|Exhibit List: Exhibit 24.1 - Power of Attorney|
||/s/ Bo Shi, as attorney-in-fact for Bevin Brown
||** Signature of Reporting Person
|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,
|** Intentional misstatements or omissions of facts constitute Federal Criminal Violations
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,
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.|
POWER OF ATTORNEY
FOR EXECUTING FORM ID, FORMS 3, FORMS 4 AND FORMS 5,
FORM 144 AND SCHEDULE 13D AND SCHEDULE 13G
The undersigned hereby constitutes and appoints Todd Falk and Bo Shi, with full
power of substitution, as the undersigned's true and lawful attorney-in-fact to:
1. Execute for and on behalf of the undersigned a Form ID (including
amendments thereto), or any other forms prescribed by the Securities
and Exchange Commission, that may be necessary to obtain codes and
passwords enabling the undersigned to make electronic filings with the
Securities and Exchange Commission of the forms referenced in clause
2. Execute for and on behalf of the undersigned any (a) Form 3, Form 4
and Form 5 (including amendments thereto) in accordance with Section
16(a) of the Securities Exchange Act of 1934, as amended (the
"Exchange Act"), (b) Form 144 (including amendments thereto) and (c)
Schedule 13D and Schedule 13G (including amendments thereto) in
accordance with Sections 13(d) and 13(g) of the Exchange Act, but only
to the extent each form or schedule relates to the undersigned's
beneficial ownership of securities of Crescent Energy Company or any
of its subsidiaries;
3. Do and perform any and all acts for and on behalf of the undersigned
that may be necessary or desirable to complete and execute any Form
ID, Form 3, Form 4, Form 5, Form 144, Schedule 13D or Schedule 13G
(including amendments thereto) and timely file the forms or schedules
with the Securities and Exchange Commission and any stock exchange or
quotation system, self-regulatory association or any other authority,
and provide a copy as required by law or advisable to such persons as
the attorney-in-fact deems appropriate; and
4. Take any other action in connection with the foregoing that, in the
opinion of the attorney-in-fact, may be of benefit to, in the best
interest of or legally required of the undersigned, it being
understood that the documents executed by the attorney-in-fact on
behalf of the undersigned pursuant to this Power of Attorney shall be
in the form and shall contain the terms and conditions as the
attorney-in-fact may approve in the attorney-in-fact's discretion.
The undersigned hereby grants to the attorney-in-fact full power and authority
to do and perform all and every act requisite, necessary or proper to be done in
the exercise of any of the rights and powers granted herein, as fully to all
intents and purposes as the undersigned might or could do if personally present,
with full power of substitution or revocation, hereby ratifying and confirming
all that the attorney-in-fact shall lawfully do or cause to be done by virtue of
this Power of Attorney and the rights and powers granted herein. The
undersigned acknowledges that the attorney-in-fact, in serving in such capacity
at the request of the undersigned, are not assuming (nor is Crescent Energy
Company assuming) any of the undersigned's responsibilities to comply with
Section 16 of the Exchange Act.
The undersigned agrees that the attorney-in-fact may rely entirely on
information furnished orally or in writing by or at the direction of the
undersigned to the attorney-in-fact.
This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Form ID, Form 3, Form 4, Form 5, Form
144, Schedule 13D and Schedule 13G (including amendments thereto) with respect
to the undersigned's holdings of and transactions in securities issued by
Crescent Energy Company, unless earlier revoked by the undersigned in a signed
writing delivered to the attorney-in-fact. This Power of Attorney does not
revoke any other power of attorney that the undersigned has previously granted.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of the date written below.
/s/ Bevin Brown
Type or Print Name
December 7, 2021