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OMB APPROVAL
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- -------- OMB Number: 3235-0104
FORM 3 Expires: September 30, 1998
- -------- Estimated average burden
hours per response .... 0.5
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U.S. 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,
Section 17(a) of the Public Utility Holding Company Act of 1935 or
Section 30(f) of the Investment Company Act of 1940
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<S> <C> <C> <C>
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1. Name and Address of Reporting Person* 2. Date of Event Requiring 4. Issuer Name and Ticker or 6. If Amendment, Date
Statement Trading Symbol of Original
Brooksher Robert R. (Month/Day/Year) PetroQuest Energy, Inc. - PQUE (Month/Day/Year)
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(Last) (First) (Middle) 9/1/98 5. Relationship of Reporting -----------------------
625 E. Kaliste Saloom Rd., Suite 400 ---------------------------- Person(s) to Issuer 7. Individual or Joint/
- ---------------------------------------- 3. IRS or Social Security (Check all applicable) Group Filing (Check
(Street) Number of Reporting X Director 10% Owner Applicable Line)
Person (Voluntary) ----- ----- X Form filed by
Lafayette Louisiana 70508 X Officer Other (specify --- One Reporting
- -------------------------------------- ----- ----- below) Person
(City) (State) (Zip) ---------------------------- (give title below) Form filed by
Chief Financial Officer and Secretary --- More than One
------------------------------------- Reporting Person
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TABLE I -- NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED
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1. Title of Security 2. Amount of Securities 3. Ownership Form: 4. Nature of Indirect
(Instr. 4) Beneficially Owned Direct (D) or Beneficial
(Instr. 4) Indirect (I) Ownership (Instr. 5)
(Instr. 5)
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Common Stock 11,600 D
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over)
*If the form is filed by more than one reporting person, see Instruction 5(b)(v). SEC 1473 (7-96)
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FORM 3 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES BENEFICIALLY OWNED
(E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
<S> <C> <C> <C> <C> <C>
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1. Title of Derivative Security 2. Date 3. Title and Amount of 4. Conver- 5. Owner- 6. Nature of Indirect
(Instr. 4) Exercisable and Securities Underlying sion or ship Beneficial Ownership
Expiration Date Derivative Security Exercise Form of (Instr. 5)
(Month/Day/ (Instr. 4) Price of Deriv-
Year) Deri- ative
vative Security:
Security Direct
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Brooksher, Robert R. Date Expira- Amount or Indirect (I)
Exercis- tion Title Number (Instr. 5)
able Date of Shares
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Nonstatutory Stock Options
pursuant to 1998 Incentive Plan (1) 9/1/08 Common Stock 38,000 $ .8479 D
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Option to Acquire Common Stock(2) 9/1/98 9/1/01 Common Stock 366,750 (2) D
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Option to Acquire Contigent
Interest Rights in Common
Stock (2)(3) 9/1/98 9/1/01 Common Stock 83,350 (2) D
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Explanation of Responses:
(1) Options will vest in 1/3 installments on each of 12/31/98, 12/31/99 and 12/31/00.
(2) Mr. Brookshear has an oral agreement with Charles T. Goodson, Alfred J. Thomas, II, Janell B. Thomas, Alfred J. Thomas, III,
Blaine A. Thomas, Natalie A. Thomas and Ralph J. Daigle whereby he has an option to purchase Common Stock and Contingent
Interest Rights in Common Stock held by them for $600,000.
(3) If on or before 9/1/01 the PetroQuest Energy, Inc. Common Stock has a Fair Market Value at or above U.S. $5.00 per share (as
adjusted for stock splits, combinations and other similar corporate events) for a period of 20 consecutive trading days, the
holder of the Contingent Interest Right
shall be considered the record holder
of the designated number of shares of
Common Stock.
/s/ Robert R. Brooksher September 9, 1998
**Intentional misstatements or omissions of facts constitute Federal Criminal ------------------------------- -----------------
Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). **Signature of Reporting Person Date
Robert R. Brooksher
Note. File three copies of this Form, one of which must be manually signed.
If space provided is insufficient, See instruction 6 for procedure.
Potential persons who are to respond to the collection of information contained in this form are not required to respond unless
the form displays a currently valid OMB Number.
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SEC 1473 (7-96)
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