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OMB APPROVAL
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- ------ OMB Number: 3235-0362
FORM 5 Expires: October 31, 2001
- ------ Estimated average burden
hours per response.... 1.0
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, DC 20549
ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
[ ] CHECK BOX IF NO
LONGER SUBJECT TO
SECTION 16. FORM
4 OR FORM 5
OBLIGATIONS MAY
CONTINUE. SEE Filed pursuant to Section 16(a) of the Securities
INSTRUCTION 1(b). Exchange Act of 1934,
[ ] FORM 3 HOLDINGS Section 17(a) of the Public Utility
REPORTED Holding Company Act of 1935 or Section 30(f) of
[ ] FORM 4 the Investment Company Act
TRANSACTIONS of 1940
REPORTED
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<S> <C> <C> <C> <C> <C> <C>
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1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person(s) to
Daigle Ralph J. PetroQuest Energy, Inc. -- PQUE Issuer (Check all applicable)
- ------------------------------------------- --------------------------------------------- X Director X 10% Owner
(Last) (First) (Middle) 3. I.R.S. Identification 4. Statement for ---- ---
400 E. Kaliste Saloom Rd., Suite 3000 Number of Reporting Month/Year X Officer (give Other (specify
- ------------------------------------------- Person (Voluntary) 12/31/99 ---- title --- below)
(Street) ------------------- below)
Lafayette Louisiana 70508 5. If Amendment, Senior Vice President - Exploration
- ------------------------------------------- Date of Original -----------------------------------
(City) (State) (Zip) (Month/Year)
7. Individual or Joint/Group Reporting
------------------ (Check Applicable Line)
X Form filed by One
---- Reporting Person
Form filed by More than
---- One Reporting Person
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TABLE I -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
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1. Title of Security 2. Trans- 3. Transac- 4. Securities Acquired (A) 5. Amount of Se- 6. Owner- 7. Nature
(Instr. 3) action tion or Disposed of (D) curities Benefi- ship of In-
Date Code (Instr. 3, 4 and 5) cially Owned at Form: direct
(Month/ (Instr. End of Issuer's Direct Benefi-
Day/ 8) Fiscal Year (D) or cial
Year) ---------------------------- (Instr. 3 and 4) Indirect Owner-
Amount (A) or Price (I) ship
(D) (Instr. 4) (Instr. 4)
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Common Stock 12/28/99 G 26,000 D 2,161,500 D
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Common Stock 12/28/99 G(1) 13,000 D 13,000 I By daughter
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(1) Gift by reporting person to his daughter.
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*If the form is filed by more than one reporting person, see Instruction 4(b)(v).
(Over)
SEC 2270 (7-96)
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<TABLE>
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FORM 5 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
(e.g., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
<S> <C> <C> <C> <C> <C> <C> <C>
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1. Title of Derivative 2. Conver- 3. Trans- 4. Trans- 5. Number of 6. Date Exer- 7. Title and Amount 8. Price
Security sion or action action Derivative cisable and of Underlying of
(Instr. 3) Exercise Date Code Securities Ac- Expiration Securities Derivative
Price of (Month/ (Instr. 8) quired (A) or Date (Instr. 3 and 4) Security
Deriv- Day/ Disposed of (D) (Month/Day/ (Instr. 5)
ative Year) (Instr. 3, 4, Year)
Security and 5)
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Date Expira- Amount or
--------------- Exer- tion Number of
(A) (D) cisable Date Title Shares
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<S> <C> <C>
9. Number of 10. Ownership 11. Nature of
Derivative of Derivative Indirect
Securities Security: Beneficial
Beneficially Direct (D) Ownership
Owned at End or Indirect (I) (Instr. 4)
of Year (Instr. 4)
(Instr. 4)
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EXPLANATION OF RESPONSES:
**Intentional misstatements or omissions of facts constitute Federal Criminal Violations. /s/ RALPH J. DAIGLE 2/10/2000
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). ------------------------------- ---------
**Signature of Reporting Person Date
Note. File three copies of this Form, one of which must be manually signed.
If space 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. Page 2
SEC 2270 (7-06)
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