Form D

FORM D

Notice of Exempt Offering of Securities

UNITED STATES SECURITIES
AND EXCHANGE COMMISSION
Washington, D.C.

OMB APPROVAL

OMB Number: 3235-0076

Estimated Average burden hours per response: 4.0

1. Issuer's Identity

CIK (Filer ID Number)

Previous Name(s)

None

Entity Type

0001879527

Corporation

Limited Partnership

Limited Liability Company

General Partnership

Business Trust

Other

Name of Issuer

2021 Permian Basin JV, GP

Jurisdiction of Incorporation/Organization

TEXAS

Year of Incorporation/Organization

Over Five Years Ago

Within Last Five Years (Specify Year)

2021

Yet to Be Formed

2. Principal Place of Business and Contact Information

Name of Issuer

2021 Permian Basin JV, GP

Street Address 1

Street Address 2

2112 INDIANA

City

State/Province/Country

ZIP/Postal Code

Phone No. of Issuer

LUBBOCK

TEXAS

79410

4326858536

3. Related Persons

Last Name

First Name

Middle Name

Massey

Jon

Street Address 1

Street Address 2

P.O. Box 10

City

State/Province/Country

ZIP/Postal Code

Folsom

LOUISIANA

70437

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Last Name

First Name

Middle Name

James

Austin

Street Address 1

Street Address 2

2802 Parker

City

State/Province/Country

ZIP/Postal Code

Amarillo

TEXAS

79109

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Last Name

First Name

Middle Name

Boyd

Phillip

Scott

Street Address 1

Street Address 2

927 Friendship Rd.

City

State/Province/Country

ZIP/Postal Code

Weatherford

TEXAS

76085

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Last Name

First Name

Middle Name

Clayton

John

Street Address 1

Street Address 2

690 CR 137

City

State/Province/Country

ZIP/Postal Code

Snyder

TEXAS

79549

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Last Name

First Name

Middle Name

Cox

Cody

Street Address 1

Street Address 2

4702 111th Street

City

State/Province/Country

ZIP/Postal Code

Lubbock

TEXAS

79424

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Cody Cox is a partner of Cody & Sandra Cox, Ltd., an investor in this general partnership

Last Name

First Name

Middle Name

Cox

Sandra

Street Address 1

Street Address 2

4702 111th Street

City

State/Province/Country

ZIP/Postal Code

Lubbock

TEXAS

79424

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Sandra Cox is a partner of Cody & Sandra Cox, Ltd., an investor in this general partnership

Last Name

First Name

Middle Name

Dillard

Fred

Street Address 1

Street Address 2

P.O. Box 1238

City

State/Province/Country

ZIP/Postal Code

Snyder

TEXAS

79550

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Last Name

First Name

Middle Name

Echols

Van

Street Address 1

Street Address 2

8413 Saratoga Ave.

City

State/Province/Country

ZIP/Postal Code

Lubbock

TEXAS

79424

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Last Name

First Name

Middle Name

Field

Mike

Street Address 1

Street Address 2

2112 Indiana

City

State/Province/Country

ZIP/Postal Code

Lubbock

TEXAS

79410

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Last Name

First Name

Middle Name

Fitz

Job

Street Address 1

Street Address 2

4905 97th Street

City

State/Province/Country

ZIP/Postal Code

Lubbock

TEXAS

79424

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Last Name

First Name

Middle Name

Foley

Charles

Street Address 1

Street Address 2

6903 86th Street

City

State/Province/Country

ZIP/Postal Code

Lubbock

TEXAS

79424

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Last Name

First Name

Middle Name

Harless

John

Mark

Street Address 1

Street Address 2

P.O. Box 36

City

State/Province/Country

ZIP/Postal Code

Ira

TEXAS

79527

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Last Name

First Name

Middle Name

Harris

Bryan

Street Address 1

Street Address 2

11001 Salem Ave.

City

State/Province/Country

ZIP/Postal Code

Lubbock

TEXAS

79424

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Last Name

First Name

Middle Name

Heider

Matthew

Street Address 1

Street Address 2

4714 104th

City

State/Province/Country

ZIP/Postal Code

Lubbock

TEXAS

79424

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Last Name

First Name

Middle Name

Hubbard

Diane

Street Address 1

Street Address 2

7822 Orlando Ave.

City

State/Province/Country

ZIP/Postal Code

Lubbock

TEXAS

79423

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Last Name

First Name

Middle Name

Knapp

Michael

Street Address 1

Street Address 2

5404 County Road 7530

City

State/Province/Country

ZIP/Postal Code

Lubbock

TEXAS

79424

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Last Name

First Name

Middle Name

Long

David

Street Address 1

Street Address 2

6610 Norwood Ave.

City

State/Province/Country

ZIP/Postal Code

Lubbock

TEXAS

79413

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Last Name

First Name

Middle Name

Long

Zachary

Street Address 1

Street Address 2

3811 64th Drive

City

State/Province/Country

ZIP/Postal Code

Lubbock

TEXAS

79413

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Last Name

First Name

Middle Name

Lovelady

Samuel

Street Address 1

Street Address 2

801 S. Fillmore, Suite 420

City

State/Province/Country

ZIP/Postal Code

Amarillo

TEXAS

79101

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Last Name

First Name

Middle Name

Martin

Richard

Street Address 1

Street Address 2

4633 89th Street

City

State/Province/Country

ZIP/Postal Code

Lubbock

TEXAS

79424

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Last Name

First Name

Middle Name

Moxley

Heather

Street Address 1

Street Address 2

3621 60th Street

City

State/Province/Country

ZIP/Postal Code

Lubbock

TEXAS

79413

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Last Name

First Name

Middle Name

Newsom

John

Street Address 1

Street Address 2

8101 CR 6920

City

State/Province/Country

ZIP/Postal Code

Lubbock

TEXAS

79407

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Last Name

First Name

Middle Name

Ross

Stephen

Street Address 1

Street Address 2

P.O. Box 353

City

State/Province/Country

ZIP/Postal Code

Kingston

OKLAHOMA

73439

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Last Name

First Name

Middle Name

House

Jay

Street Address 1

Street Address 2

4609 86th Street

City

State/Province/Country

ZIP/Postal Code

Lubbock

TEXAS

79424

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Jay House, is a member of Schofield Investments, LLC, an investor in this general partnership

Last Name

First Name

Middle Name

McMillan

Dick

Street Address 1

Street Address 2

550 W. Texas, Suite 945

City

State/Province/Country

ZIP/Postal Code

Midland

TEXAS

79701

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Dick McMillan is a member of LMC Energy, LLC, an investor in this general partnership

Last Name

First Name

Middle Name

Siebenlist

Levi

Street Address 1

Street Address 2

2112 Indiana

City

State/Province/Country

ZIP/Postal Code

Lubbock

TEXAS

79410

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Last Name

First Name

Middle Name

Smith

Carl

Street Address 1

Street Address 2

2601 47th Street

City

State/Province/Country

ZIP/Postal Code

Snyder

TEXAS

79549

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Last Name

First Name

Middle Name

Thomason

Elizabeth

Street Address 1

Street Address 2

5531 Woodward Road

City

State/Province/Country

ZIP/Postal Code

Lubbock

TEXAS

79424

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

Last Name

First Name

Middle Name

Vinson

Jeff

Street Address 1

Street Address 2

7822 Orlando Ave.

City

State/Province/Country

ZIP/Postal Code

Lubbock

TEXAS

79423

Relationship:

Executive Officer

Director

Promoter

Clarification of Response (if Necessary)

4. Industry Group

Agriculture

Banking & Financial Services

Commercial Banking

Insurance

Investing

Investment Banking

Pooled Investment Fund

Other Banking & Financial Services

Business Services

Energy

Coal Mining

Electric Utilities

Energy Conservation

Environmental Services

Oil & Gas

Other Energy

Health Care

Biotechnology

Health Insurance

Hospitals & Physicians

Pharmaceuticals

Other Health Care

Manufacturing

Real Estate

Commercial

Construction

REITS & Finance

Residential

Other Real Estate

Retailing

Restaurants

Technology

Computers

Telecommunications

Other Technology

Travel

Airlines & Airports

Lodging & Conventions

Tourism & Travel Services

Other Travel

Other

5. Issuer Size

Revenue Range

Aggregate Net Asset Value Range

No Revenues

No Aggregate Net Asset Value

$1 - $1,000,000

$1 - $5,000,000

$1,000,001 - $5,000,000

$5,000,001 - $25,000,000

$25,000,001 - $50,000,000

$25,000,001 - $100,000,000

$50,000,001 - $100,000,000

Over $100,000,000

Decline to Disclose

Not Applicable

6. Federal Exemption(s) and Exclusion(s) Claimed (select all that apply)

Rule 504(b)(1) (not (i), (ii)
or (iii))

Rule 506(b)

Rule 504 (b)(1)(i)

Rule 506(c)

Rule 504 (b)(1)(ii)

Securities Act Section 4(a)(5)

Rule 504 (b)(1)(iii)

Investment Company Act Section 3(c)

7. Type of Filing

New Notice

Date of First Sale

2021-08-06

First Sale Yet to Occur

Amendment

8. Duration of Offering

Does the Issuer intend this offering to last more than one year?

Yes

9. Type(s) of Securities Offered (select all that apply)

Pooled Investment Fund Interests

Equity

Tenant-in-Common Securities

Debt

Mineral Property Securities

Option, Warrant or Other Right to Acquire Another Security

Security to be Acquired Upon Exercise of Option, Warrant or Other Right to Acquire Security

Other (describe)

10. Business Combination Transaction

Is this offering being made in connection with a business combination transaction, such as a merger, acquisition or exchange offer?

Yes

Clarification of Response (if Necessary)

11. Minimum Investment

Minimum investment accepted from any outside investor

50000

USD

12. Sales Compensation

Recipient

Recipient CRD Number

None

(Associated) Broker or Dealer

None

(Associated) Broker or Dealer CRD Number

None

Street Address 1

Street Address 2

City

State/Province/Country

ZIP/Postal Code

State(s) of Solicitation

All States

13. Offering and Sales Amounts

Total Offering Amount

USD

Indefinite

Total Amount Sold

2825000

USD

Total Remaining to be Sold

USD

Indefinite

Clarification of Response (if Necessary)

14. Investors

Select if securities in the offering have been or may be sold to persons who do not qualify as accredited investors,
Number of such non-accredited investors who already have invested in the offering

Regardless of whether securities in the offering have been or may be sold to persons who do not qualify as accredited investors, enter the total number of investors who already have invested in the offering:

15. Sales Commissions & Finders’ Fees Expenses

Provide separately the amounts of sales commissions and finders' fees expenses, if any. If the amount of an expenditure is not known, provide an estimate and check the box next to the amount.

Sales Commissions

USD

Estimate

Finders' Fees

USD

Estimate

Clarification of Response (if Necessary)

16. Use of Proceeds

Provide the amount of the gross proceeds of the offering that has been or is proposed to be used for payments to any of the persons required to be named as executive officers, directors or promoters in response to Item 3 above. If the amount is unknown, provide an estimate and check the box next to the amount.

USD

Estimate

Clarification of Response (if Necessary)

Signature and Submission

Please verify the information you have entered and review the Terms of Submission below before signing and clicking SUBMIT below to file this notice.

Terms of Submission

In submitting this notice, each Issuer named above is:

Notifying the SEC and/or each State in which this notice is filed of the offering of securities described and undertaking to furnish them, upon written request, the information furnished to offerees.

Irrevocably appointing each of the Secretary of the SEC and, the Securities Administrator or other legally designated officer of the State in which the Issuer maintains its principal place of business and any State in which this notice is filed, as its agents for service of process, and agreeing that these persons may accept service on its behalf, of any notice, process or pleading, and further agreeing that such service may be made by registered or certified mail, in any Federal or state action, administrative proceeding, or arbitration brought against it in any place subject to the jurisdiction of the United States, if the action, proceeding or arbitration (a) arises out of any activity in connection with the offering of securities that is the subject of this notice, and (b) is founded, directly or indirectly, upon the provisions of: (i) the Securities Act of 1933, the Securities Exchange Act of 1934, the Trust Indenture Act of 1939, the Investment Company Act of 1940, or the Investment Advisers Act of 1940, or any rule or regulation under any of these statutes, or (ii) the laws of the State in which the issuer maintains its principal place of business or any State in which this notice is filed.

Certifying that, if the issuer is claiming a Regulation D exemption for the offering, the issuer is not disqualified from relying on Rule 504 or Rule 506 for one of the reasons stated in Rule 504(b)(3) or Rule 506(d).

Each Issuer identified above has read this notice, knows the contents to be true, and has duly caused this notice to be signed on its behalf by the undersigned duly authorized person.

For signature, type in the signer's name or other letters or characters adopted or authorized as the signer's signature.

Issuer

Signature

Name of Signer

Title

Date

2021 Permian Basin JV, GP

Jon Massey

Managing Partner

2021-08-20