Empire Petroleum Corporation

04/24/2024 | Press release | Distributed by Public on 04/24/2024 19:52

Amendment to Initial Statement of Beneficial Ownership - Form 3/A

Ownership Submission
FORM 3/A
UNITED STATES 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 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person *
Mulacek Phil E
2. Date of Event Requiring Statement (Month/Day/Year)
2021-03-15
3. Issuer Name and Ticker or Trading Symbol
EMPIRE PETROLEUM CORP [EP]
(Last) (First) (Middle)
25025 I 45 NORTH , SUITE 420
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
5. If Amendment, Date Original Filed(Month/Day/Year)
2021-03-24
(Street)
THE WOODLANDS TX 77380
6. Individual or Join/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Beneficially Owned
1.Title of Security 2. Amount of Securities Beneficially Owned 3. Ownership Form: Direct (D) or Indirect (I) 4. Nature of Indirect Beneficial Ownership
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivate Security 2. Date Exercisable and Expiration Date 3. Title and Amount of Securities Underlying Derivative Security 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) 6. Nature of Indirect Beneficial Ownership
Date Exercisable Expriation Date Title Amount or Number of Shares

Reporting Owners

Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Mulacek Phil E
25025 I 45 NORTH
SUITE 420
THE WOODLANDS, TX77380
X X

Signatures

/s/ Phil E. Mulacek 2024-04-24
**Signature of Reporting Person Date

Explanation of Responses:

(*) 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).
(1) All share numbers and exercise prices are stated prior to giving effect to Empire's 1-for-4 reverse common stock split, which became effective on March 7, 2022.
(2) This amendment is being filed to report 8,996 shares of common stock that were erroneously omitted from the beneficial ownership of Five Sterling LP.
(3) This amendment is being filed to report 2,896 shares of common stock that were erroneously omitted from the beneficial ownership of Mr. Mulacek's spouse.
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.