SEC FORM
3
SEC Form 3
| FORM 3 |
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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| OMB APPROVAL |
| OMB Number: |
3235-0104 |
| Estimated average burden |
| hours per response: |
0.5 |
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1. Name and Address of Reporting Person*
| 1050 17TH STREET, SUITE 500 |
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(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year)
06/01/2012
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3. Issuer Name and Ticker or Trading Symbol
QEP RESOURCES, INC.
[ QEP ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
Director |
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10% Owner |
| X |
Officer (give title below) |
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Other (specify below) |
| VP & Controller |
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5. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
| X |
Form filed by One Reporting Person |
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Form filed by More than One Reporting Person |
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| Table I - Non-Derivative Securities Beneficially Owned |
|---|
| 1. Title of Security (Instr.
4)
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2.
Amount of Securities Beneficially Owned (Instr.
4)
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3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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4. Nature of Indirect Beneficial Ownership (Instr.
5)
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| Common Stock |
13,703 |
D |
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Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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|---|
| 1. Title of Derivative Security (Instr.
4)
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2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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6. Nature of Indirect Beneficial Ownership (Instr.
5)
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| Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
| Phantom Stock Units |
|
|
Phantom Stock Units |
3,483 |
0.00 |
D |
|
| Stock Option |
|
04/01/2019 |
Common Stock |
2,891 |
30.5 |
D |
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| Explanation of Responses: |
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| Remarks: |
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Abigail L. Jones, Attorney in Fact |
06/05/2012 |
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** Signature of Reporting Person |
Date |
| Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
| * 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). |
| Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure. |
| Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |
POWER OF ATTORNEY
REPORTS, SECURITIES TRANSACTIONS
I, Kendall K. Carbone, 1050 17th Street, Suite 500, Denver, Colorado, as an
Officer of QEP Resources, Inc. (the "Company"), do hereby appoint Abigail L.
Jones Richard J. Doleshek and Eric L. Dady, or each of them acting alone, my
true and lawful attorney-in-fact to sign any Form 3, Form 4, Form 5, or Form 144
Reports that I am required to file with the Securities and Exchange Commission
reporting transactions involving shares of the Company's common stock and
derivative securities whose value is dependent on such shares, including option
grants and phantom stock units allocated to my accounts under the terms of
deferred compensation plans adopted by the Company and its subsidiaries.
I acknowledge that Ms. Jones, Mr. Doleshek and Mr. Dady are not assuming any
responsibility that I have to comply with federal securities laws, including
compliance with Section 16 of the Security and Exchange Act of 1934.
This Power of Attorney shall remain in full force and effect with respect to my
holdings of any transactions of securities issued by the Company as long as I am
required to make reports of my transactions, unless I revoke it with a signed
writing prior to such date.
