|4Jan 6, 2:19 PM ET

THREE FORKS, INC. 4

4 · THREE FORKS, INC. · Filed Jan 6, 2015

Insider Transaction Report

Form 4
Period: 2014-11-27
POLLARD CHARLES WILLIAM
DirectorChief Operating Officer
Transactions
  • Other

    Option

    2014-11-27$1.00/sh50,000$50,0000 total
    Exercise: $1.00Common Stock (50,000 underlying)
  • Other

    Option

    2014-11-27$0.10/sh1,750,000$175,000500,000 total
    Exercise: $0.10Common Stock (1,750,000 underlying)
Footnotes (2)
  • [F1]Mr. Pollard surrendered to the Company 1,750,000 of the $0.10 Options issued to him for immediate cancellation by the Company in connection with the Resignation and Settlement Agreement dated 11/27/2014.
  • [F2]Mr. Pollard surrendered to the Company 50,000 of the $1.00 Options issued to him for immediate cancellation by the Company in connection with the Resignation and Settlement Agreement dated 11/27/2014.

Documents

1 file
  • 4
    primary_doc.xmlPrimary

    PRIMARY DOCUMENT