Form 4 U.S. WELL SERVICES, INC. For: May 14 Filed by: Broussard Joel

May 20, 2022 9:00 PM EDT

Get inside Wall Street with StreetInsider Premium. Claim your 1-week free trial here.
Washington, D.C. 20549


Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
OMB Number: 3235-0287
Expires: December 31, 2014
Estimated average burden
hours per response: 0.5
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 *
Broussard Joel

(Last) (First) (Middle)


(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) X Other (specify below)
Chairman of the Board
3. Date of Earliest Transaction (Month/Day/Year)
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
Class A Common Stock 05/20/2022   D   61,400 D $ 0 (1) 559,113 D  
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
Deferred Stock Units (2) 05/14/2021   A   1,026,513     (3)   (3) Class A Common Stock 1,026,513 $ 0 2,328,046 D  
Deferred Stock Units (2) 08/16/2021   A   71,826     (3)   (3) Class A Common Stock 71,826 $ 0 2,240,853 (4) D  
Explanation of Responses:
1. The restricted stock was forfeited pursuant to a Forfeiture Agreement entered into by and between the Issuer and the Reporting Person.
2. Each Deferred Stock Unit represents a contingent right to receive one share of the Issuer's Class A common stock, par value $0.0001 per share (the "Common Stock").
3. The shares of Common Stock issuable with respect to vested Deferred Stock Units shall be issued in a lump sum on the earlier of the following dates and otherwise only as follows: (a) The 60th day after a termination of the Reporting Persons Continuous Service; (b) The consummation of a Change in Control (with such issuance deemed to occur as of immediately prior to such Change in Control to the extent permitted under Code Section 409A, but with the timing of such issuance otherwise determined by the Company); and (c) Upon the fifth (5th) anniversary of the Grant Date. Defined terms used but not defined herein shall have the meaning ascribed to such term in the Deferred Stock Unit Award Agreement.
4. Reduced by 159,019 stock options forfeited for no consideration in May 2022.
/s/ Erin C. Simonson, Attorney-in-Fact 05/20/2022
** 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see 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.

Serious News for Serious Traders! Try Premium Free!

You May Also Be Interested In

Related Categories

SEC Filings