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OMB APPROVAL
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- -------- OMB Number 3235-0104
FORM 3 Expires: December 31, 2001
- -------- 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
Langner Jay B. (Month/Day/Year) PetroQuest Energy, Inc. (PQUE) (Month/Day/Year)
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(Last) (First) (Middle) 4/3/00 5. Relationship of Reporting -----------------------
P.O. Box 355 ---------------------------- 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
Great Neck New York 11022 Officer Other (specify --- One Reporting
- -------------------------------------- ----- ----- below) Person
(City) (State) (Zip) ---------------------------- (give title below) Form filed by
--- 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 100,000 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
------------------------------------------------- (D) or
Date Expira- Amount or Indirect (I)
Exercis- tion Title Number (Instr. 5)
able Date of Shares
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Warrant to Purchase Shares of
Common Stock of PetroQuest
Energy, Inc. 8/31/99 8/30/03 Common Stock 50,000 $1.25 D
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Nonstatutory Stock Options
pursuant to 1998 Incentive
Plan 4/3/00 4/3/10 Common Stock 50,000 $1.81 D
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Explanation of Responses:
/s/ JAY B. LANGNER 4/11/00
**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
Note: File three copies of this Form, one of which must be manually signed. Page 2
If space is insufficient, See Instruction 6 for procedure. SEC 1473 (7-96)
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Potential persons who are to respond to the collection of information contained
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