SEC Form 3 | ||||||||||||||||||||||||||||
FORM 3 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION | |||||||||||||||||||||||||||
OMB APPROVAL | ||||||||||||||||||||||||||||
Washington, D.C. 20549 | ||||||||||||||||||||||||||||
OMB Number: | 3235-0104 | |||||||||||||||||||||||||||
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF | Estimated average burden | |||||||||||||||||||||||||||
hours per response: | 0.5 | |||||||||||||||||||||||||||
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 | ||||||||||||||||||||||||||||
1. Name and Address of Reporting Person * | 2. Date of Event Requiring | 3. Issuer Name and Ticker or Trading Symbol | ||||||||||||||||||||||||||
Monk Christopher J | Statement | Altus Midstream Co[ ALTM ] | ||||||||||||||||||||||||||
(Month/Day/Year) | ||||||||||||||||||||||||||||
12/19/2019 | 4. Relationship of Reporting Person(s) to Issuer | 5. If Amendment, Date of Original Filed | ||||||||||||||||||||||||||
(Last) | (First) | (Middle) | (Check all applicable) | (Month/Day/Year) | ||||||||||||||||||||||||
2000 POST OASK BLVD, STE 100 | X Director | 10% Owner | 6. Individual or Joint/Group Filing (Check | |||||||||||||||||||||||||
Officer (give title | Other (specify | |||||||||||||||||||||||||||
Applicable Line) | ||||||||||||||||||||||||||||
below) | below) | X Form filed by One Reporting Person | ||||||||||||||||||||||||||
(Street) | ||||||||||||||||||||||||||||
Form filed by More than One | ||||||||||||||||||||||||||||
HOUSTON | TX | 77056 | ||||||||||||||||||||||||||
Reporting Person | ||||||||||||||||||||||||||||
(City) | (State) | (Zip) | ||||||||||||||||||||||||||
Table I - Non-Derivative Securities Beneficially Owned | ||||||||||||||||||||||||||||
1. Title of Security (Instr. 4) | 2. Amount of Securities | 3. Ownership | 4. Nature of Indirect Beneficial Ownership | |||||||||||||||||||||||||
Beneficially Owned (Instr. 4) | Form: Direct (D) | (Instr. 5) | ||||||||||||||||||||||||||
or Indirect (I) | ||||||||||||||||||||||||||||
(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 | 3. Title and Amount of Securities | 4. | 5. | 6. Nature of Indirect | |||||||||||||||||||||||
Expiration Date | Underlying Derivative Security (Instr. 4) | Conversion | Ownership | Beneficial Ownership | ||||||||||||||||||||||||
(Month/Day/Year) | or Exercise | Form: | (Instr. 5) | |||||||||||||||||||||||||
Price of | Direct (D) | |||||||||||||||||||||||||||
Amount | ||||||||||||||||||||||||||||
Derivative | or Indirect | |||||||||||||||||||||||||||
or | Security | (I) (Instr. 5) | ||||||||||||||||||||||||||
Number | ||||||||||||||||||||||||||||
Date | Expiration | of | ||||||||||||||||||||||||||
Exercisable | Date | Title | Shares | |||||||||||||||||||||||||
Explanation of Responses: | ||||||||||||||||||||||||||||
Remarks: | ||||||||||||||||||||||||||||
Note: Also see attached Exhibit EX-24 Monk POA. | ||||||||||||||||||||||||||||
No securities are beneficially owned. | ||||||||||||||||||||||||||||
Christopher J. Monk | 12/26/2019 | |||||||||||||||||||||||||||
** 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.
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
(Limited to Execution of Forms 4 and 5)
I, Christopher J. Monk do hereby constitute and appoint Rajesh Sharma and Patrick Whitman (with full power to each of them to act alone) as my true and lawful agents and attorneys-in-fact with full power and authority to execute and deliver on my behalf in accordance with Securities and Exchange Commission rules and regulations all reports of changes in my beneficial ownership of securities issued by Altus Midstream Company on Forms 4 and 5 as may be deemed advisable. I hereby ratify and confirm all that each such agent and attorney-in-fact may do by virtue hereof with respect to reports of my beneficial ownership of securities issued by Altus Midstream Company.
This power of attorney shall remain in full force and effect until I am no longer required to file Forms 4 and 5 with respect to changes in my beneficial ownership of securities issued by Altus Midstream Company, unless earlier revoked by me in writing delivered to the attorneys-in-fact named above.
In witness whereof, I have duly executed this power of attorney on the 19th day of December 2019.
/s/ Christopher J. Monk
State of Texas County of Harris
On this 19th day of December 2019, before me personally came Christopher J. Monk, to me known, and acknowledged this instrument. Witness my hand and official seal.
/s/ Melissa Garcia
[Seal for Melissa Garcia] [Notary Public, State of Texas] [My Commission Expires 02-08-2020] [Notary ID 12640525-5]
Attachments
- Original document
- Permalink
Disclaimer
Altus Midstream Company published this content on 26 December 2019 and is solely responsible for the information contained therein. Distributed by Public, unedited and unaltered, on 26 December 2019 16:50:00 UTC