The Securities and Exchange Commission has not necessarily reviewed the information in this filing and has not determined if it is accurate and complete. The reader should not assume that the information is accurate and complete. |
|
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM D
Notice of Exempt Offering of Securities
|
| OMB APPROVAL |
| OMB Number: |
3235-0076 |
| Estimated average burden |
| hours per response: |
4.00 |
|
|
1. Issuer's Identity
| CIK (Filer ID Number) |
Previous Names |
|
Entity Type |
| 0001879527 |
|
| |
Corporation |
| |
Limited Partnership |
| |
Limited Liability Company |
| X |
General Partnership |
| |
Business Trust |
| |
Other (Specify) |
|
| Name of Issuer |
| 2021 Permian Basin JV, GP |
| Jurisdiction of Incorporation/Organization |
| TEXAS |
| Year of Incorporation/Organization |
| |
Over Five Years Ago |
| X |
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/PostalCode |
Phone Number of Issuer |
| LUBBOCK |
TEXAS |
79410 |
4326858536 |
3. Related Persons
| Last Name |
First Name |
Middle Name |
| Massey |
Jon |
G |
| Street Address 1 |
Street Address 2 |
| P.O. Box 10 |
| City |
State/Province/Country |
ZIP/PostalCode |
| Folsom |
LOUISIANA |
70437 |
| Relationship: |
X |
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/PostalCode |
| Amarillo |
TEXAS |
79109 |
| Relationship: |
X |
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/PostalCode |
| Weatherford |
TEXAS |
76085 |
| Relationship: |
X |
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/PostalCode |
| Snyder |
TEXAS |
79549 |
| Relationship: |
X |
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/PostalCode |
| Lubbock |
TEXAS |
79424 |
| Relationship: |
X |
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/PostalCode |
| Lubbock |
TEXAS |
79424 |
| Relationship: |
X |
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/PostalCode |
| Snyder |
TEXAS |
79550 |
| Relationship: |
X |
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/PostalCode |
| Lubbock |
TEXAS |
79424 |
| Relationship: |
X |
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/PostalCode |
| Lubbock |
TEXAS |
79410 |
| Relationship: |
X |
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/PostalCode |
| Lubbock |
TEXAS |
79424 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Foley |
Charles |
A |
| Street Address 1 |
Street Address 2 |
| 6903 86th Street |
| City |
State/Province/Country |
ZIP/PostalCode |
| Lubbock |
TEXAS |
79424 |
| Relationship: |
X |
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/PostalCode |
| Ira |
TEXAS |
79527 |
| Relationship: |
X |
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/PostalCode |
| Lubbock |
TEXAS |
79424 |
| Relationship: |
X |
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/PostalCode |
| Lubbock |
TEXAS |
79424 |
| Relationship: |
X |
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/PostalCode |
| Lubbock |
TEXAS |
79423 |
| Relationship: |
X |
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/PostalCode |
| Lubbock |
TEXAS |
79424 |
| Relationship: |
X |
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/PostalCode |
| Lubbock |
TEXAS |
79413 |
| Relationship: |
X |
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/PostalCode |
| Lubbock |
TEXAS |
79413 |
| Relationship: |
X |
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/PostalCode |
| Amarillo |
TEXAS |
79101 |
| Relationship: |
X |
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/PostalCode |
| Lubbock |
TEXAS |
79424 |
| Relationship: |
X |
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/PostalCode |
| Lubbock |
TEXAS |
79413 |
| Relationship: |
X |
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/PostalCode |
| Lubbock |
TEXAS |
79407 |
| Relationship: |
X |
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/PostalCode |
| Kingston |
OKLAHOMA |
73439 |
| Relationship: |
X |
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/PostalCode |
| Lubbock |
TEXAS |
79424 |
| Relationship: |
X |
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/PostalCode |
| Midland |
TEXAS |
79701 |
| Relationship: |
X |
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/PostalCode |
| Lubbock |
TEXAS |
79410 |
| Relationship: |
X |
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/PostalCode |
| Snyder |
TEXAS |
79549 |
| Relationship: |
X |
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/PostalCode |
| Lubbock |
TEXAS |
79424 |
| Relationship: |
X |
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/PostalCode |
| Lubbock |
TEXAS |
79423 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Hawthorne |
Samuel |
| Street Address 1 |
Street Address 2 |
| 3107 80th Street |
| City |
State/Province/Country |
ZIP/PostalCode |
| Lubbock |
TEXAS |
79423 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
Samuel Hawthorne is a member of 2HBR, LLC, an investor in this general partnership
| Last Name |
First Name |
Middle Name |
| Carr |
Dee |
| Street Address 1 |
Street Address 2 |
| PO Box 202 |
| City |
State/Province/Country |
ZIP/PostalCode |
| Snyder |
TEXAS |
79550 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Cleavinger |
Carrisa |
| Street Address 1 |
Street Address 2 |
| 4911 76th Street |
| City |
State/Province/Country |
ZIP/PostalCode |
| Lubbock |
TEXAS |
79424 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Cousins |
John |
| Street Address 1 |
Street Address 2 |
| 3233 Palomar Lane |
| City |
State/Province/Country |
ZIP/PostalCode |
| Dallas |
TEXAS |
75229 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Sprunger |
Adam |
| Street Address 1 |
Street Address 2 |
| 5908 Brixworth Drive |
| City |
State/Province/Country |
ZIP/PostalCode |
| Tyler |
TEXAS |
75703 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
Adam Sprunger is a member of Covey on Rise, LLC, an investor in this general partnership
| Last Name |
First Name |
Middle Name |
| Cummings |
David |
| Street Address 1 |
Street Address 2 |
| 1515 Paseo de Vaca |
| City |
State/Province/Country |
ZIP/PostalCode |
| San Angelo |
TEXAS |
76901 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Smith |
Peter |
| Street Address 1 |
Street Address 2 |
| 3807 95th Street |
| City |
State/Province/Country |
ZIP/PostalCode |
| Lubbock |
TEXAS |
79423 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
Peter Smith is a member of Dos Hermanos Operating LLC, an investor in this general partnership
| Last Name |
First Name |
Middle Name |
| Dunagan |
John |
| Street Address 1 |
Street Address 2 |
| 13833 Wellington Trace E4-140 |
| City |
State/Province/Country |
ZIP/PostalCode |
| Wellington |
FLORIDA |
33414 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
John Dunagan is a member of DU3HU LLC, Dunagan Venture Capital Fund LLC, and KCJC Pardners LLC, investors in this general partnership
| Last Name |
First Name |
Middle Name |
| Edwards |
Ben |
| Street Address 1 |
Street Address 2 |
| 220 FM 1730 |
| City |
State/Province/Country |
ZIP/PostalCode |
| Wilson |
TEXAS |
79381 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Jackson |
Mike |
| Street Address 1 |
Street Address 2 |
| 2207 Wayne Ave. |
| City |
State/Province/Country |
ZIP/PostalCode |
| Lubbock |
TEXAS |
79407 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
Mike Jackson is a member of Eliza Jack Holdings, LLC, an investor in this general partnership
| Last Name |
First Name |
Middle Name |
| Henkel |
Kim |
| Street Address 1 |
Street Address 2 |
| 902 Gardner Rd |
Unit 14 |
| City |
State/Province/Country |
ZIP/PostalCode |
| Austin |
TEXAS |
78721 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
Kim Henkel is a member of Exurbia Films, LLC, an investor in this general partnership
| Last Name |
First Name |
Middle Name |
| Field |
Dan |
| Street Address 1 |
Street Address 2 |
| PO Box 1105 |
| City |
State/Province/Country |
ZIP/PostalCode |
| Lovington |
NEW MEXICO |
88260 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Holmes |
James |
| Street Address 1 |
Street Address 2 |
| 140 N Gilpin Street |
| City |
State/Province/Country |
ZIP/PostalCode |
| Denver |
COLORADO |
80218 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
James Holmes is a partner of GCD Marion, LLP, an investor in this general partnership
| Last Name |
First Name |
Middle Name |
| Gladwell |
Troy |
| Street Address 1 |
Street Address 2 |
| 27448 Richmond Hill Rd |
| City |
State/Province/Country |
ZIP/PostalCode |
| Conifer |
COLORADO |
80433 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Gornick |
Stephen |
| Street Address 1 |
Street Address 2 |
| 2044 Crestvue Circle |
| City |
State/Province/Country |
ZIP/PostalCode |
| Golden |
COLORADO |
80401 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
Stephen Gornick is a member of Gornick Oil & Gas, LLC, an investor in this general partnership
| Last Name |
First Name |
Middle Name |
| Grifo |
Scott |
| Street Address 1 |
Street Address 2 |
| 902 Gardner Rd |
Unit 14 |
| City |
State/Province/Country |
ZIP/PostalCode |
| Austin |
TEXAS |
78721 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Mahaffey |
John |
| Street Address 1 |
Street Address 2 |
| PO Box 51785 |
| City |
State/Province/Country |
ZIP/PostalCode |
| Midland |
TEXAS |
79710 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
John Mahaffey is a member of Grizzly Land Holdings, LLC, an investor in this general partnership
| Last Name |
First Name |
Middle Name |
| Hance |
Kent |
| Street Address 1 |
Street Address 2 |
| 400 W. 15th |
Ste. 950 |
| City |
State/Province/Country |
ZIP/PostalCode |
| Austin |
TEXAS |
78701 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Hare |
Lowell |
| Street Address 1 |
Street Address 2 |
| 5300 DTC Parkway |
Suite 270 |
| City |
State/Province/Country |
ZIP/PostalCode |
| Greenwood Village |
COLORADO |
80111 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Harris |
George |
| Street Address 1 |
Street Address 2 |
| 979 Harding Drive |
| City |
State/Province/Country |
ZIP/PostalCode |
| New Orleans |
LOUISIANA |
70119 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Harrison |
Bryan |
| Street Address 1 |
Street Address 2 |
| 4 Hidden Creek Rd |
| City |
State/Province/Country |
ZIP/PostalCode |
| McGregor |
TEXAS |
76657 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Harrison |
Stephen |
| Street Address 1 |
Street Address 2 |
| 22025 Woodway Drive |
| City |
State/Province/Country |
ZIP/PostalCode |
| Waco |
TEXAS |
76712 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Hopkins |
Ronald |
| Street Address 1 |
Street Address 2 |
| 1105 Twin Lakes |
| City |
State/Province/Country |
ZIP/PostalCode |
| Lovington |
NEW MEXICO |
88260 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Horan |
John |
| Street Address 1 |
Street Address 2 |
| 6170 E Quincy Ave. |
| City |
State/Province/Country |
ZIP/PostalCode |
| Cherry Hills Village |
COLORADO |
80111 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
John Horan is a member of Horan Family Ventures JT, LLC
| Last Name |
First Name |
Middle Name |
| Bomer |
Rodney |
| Street Address 1 |
Street Address 2 |
| PO Box 2003 |
| City |
State/Province/Country |
ZIP/PostalCode |
| Big Spring |
TEXAS |
79721 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
Rodney Bomer is a member of JALA Capital Investments, LLC, an investor in this general partnership
| Last Name |
First Name |
Middle Name |
| Henderson |
JD |
| Street Address 1 |
Street Address 2 |
| 3810 111th Street |
| City |
State/Province/Country |
ZIP/PostalCode |
| Lubbock |
TEXAS |
79423 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
JD Henderson is a member of JLL Henderson Ventures, LLC, an investor in this general partnership
| Last Name |
First Name |
Middle Name |
| Johnston |
Joe |
| Street Address 1 |
Street Address 2 |
| 608 Ridgemont Ave. |
| City |
State/Province/Country |
ZIP/PostalCode |
| San Antonio |
TEXAS |
78209 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Kurdi |
Juan |
| Street Address 1 |
Street Address 2 |
| 4203 104th Street |
| City |
State/Province/Country |
ZIP/PostalCode |
| Lubbock |
TEXAS |
79423 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Lobstein |
Rick |
| Street Address 1 |
Street Address 2 |
| 1825 Golden Visa Dr. |
| City |
State/Province/Country |
ZIP/PostalCode |
| Las Vegas |
NEVADA |
89123 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Marshall |
Brad |
| Street Address 1 |
Street Address 2 |
| 121 Prairie Street |
Suite A |
| City |
State/Province/Country |
ZIP/PostalCode |
| Cleburne |
TEXAS |
76033 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| McDonald |
Jack |
| Street Address 1 |
Street Address 2 |
| 4510 Houston Ave. |
| City |
State/Province/Country |
ZIP/PostalCode |
| Snyder |
TEXAS |
79549 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Mills |
Kelly |
| Street Address 1 |
Street Address 2 |
| 4818 120th Street |
| City |
State/Province/Country |
ZIP/PostalCode |
| Lubbock |
TEXAS |
79424 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Mills |
Stacy |
| Street Address 1 |
Street Address 2 |
| PO Box 1358 |
| City |
State/Province/Country |
ZIP/PostalCode |
| Loving |
NEW MEXICO |
88256 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Nelson |
Blair |
| Street Address 1 |
Street Address 2 |
| 314 Greenway Lane |
| City |
State/Province/Country |
ZIP/PostalCode |
| Richmond |
VIRGINIA |
23226 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Hartfield |
George |
| Street Address 1 |
Street Address 2 |
| PO Box 81319 |
| City |
State/Province/Country |
ZIP/PostalCode |
| Lafayette |
LOUISIANA |
70598 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
George Hartfield is a partner in Phil-Am Investments, an investor in this general partnership
| Last Name |
First Name |
Middle Name |
| Schmid |
Robert |
| Street Address 1 |
Street Address 2 |
| 4611 20th Street |
| City |
State/Province/Country |
ZIP/PostalCode |
| Lubbock |
TEXAS |
79407 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
Robert Schmid is a partner of Schmid Holdings, LP, an investor in this general partnership
| Last Name |
First Name |
Middle Name |
| Scolaro |
Philip |
A |
| Street Address 1 |
Street Address 2 |
| 3802 22nd Street |
Suite 200 |
| City |
State/Province/Country |
ZIP/PostalCode |
| Lubbock |
TEXAS |
79410 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
Philip A. Scolaro is a member of Scolaro Energy, LLC, an investor in this general partnership
| Last Name |
First Name |
Middle Name |
| Sloan |
Lorrain |
| Street Address 1 |
Street Address 2 |
| 7915 Salta Verde Pt. |
| City |
State/Province/Country |
ZIP/PostalCode |
| Katy |
TEXAS |
77494 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Smith |
Nathan |
| Street Address 1 |
Street Address 2 |
| 5508 Royal Court |
| City |
State/Province/Country |
ZIP/PostalCode |
| Snyder |
TEXAS |
79549 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Smith |
Shane |
| Street Address 1 |
Street Address 2 |
| PO Box 81 |
| City |
State/Province/Country |
ZIP/PostalCode |
| Ira |
TEXAS |
79527 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Stone |
Stephen |
| Street Address 1 |
Street Address 2 |
| 4604 13th Street |
| City |
State/Province/Country |
ZIP/PostalCode |
| Lubbock |
TEXAS |
79416 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Tschetter |
Mark |
| Street Address 1 |
Street Address 2 |
| 3600 S Yosemite St |
| City |
State/Province/Country |
ZIP/PostalCode |
| Denver |
COLORADO |
80237 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Turner |
John |
C |
| Street Address 1 |
Street Address 2 |
| 8708 Canyon Dr. |
| City |
State/Province/Country |
ZIP/PostalCode |
| Dallas |
TEXAS |
75209 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
| Last Name |
First Name |
Middle Name |
| Butterworth |
Taylor |
| Street Address 1 |
Street Address 2 |
| 19 Cypress Rd |
| City |
State/Province/Country |
ZIP/PostalCode |
| Covington |
LOUISIANA |
70433 |
| Relationship: |
X |
Executive Officer |
|
Director |
|
Promoter |
Clarification of Response (if Necessary):
Taylor Butterworth is a member of Updip Exploration, LLC, an investor in this general partnership
| Last Name |
First Name |
Middle Name |
| Walker |
John |
Tracy |
| Street Address 1 |
Street Address 2 |
| 23 Highland Road |
| City |
State/Province/Country |
ZIP/PostalCode |
| Richmond |
VIRGINIA |
23229 |
| Relationship: |
X |
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 |
|
|
|
Is the issuer registered as an investment company under the Investment Company Act of 1940? |
|
|
| |
Other Banking & Financial Services |
|
| |
Business Services |
|
Energy |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Health Care |
|
|
|
|
|
|
|
|
|
|
| |
Manufacturing |
|
Real Estate |
|
|
|
|
|
|
|
|
|
|
|
|
Retailing |
|
Restaurants |
|
Technology |
|
|
|
|
|
|
|
Travel |
|
|
|
|
|
| |
Tourism & Travel Services |
|
|
|
|
Other |
|
5. Issuer Size
| Revenue Range |
OR |
Aggregate Net Asset Value Range |
| X |
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 |
| |
$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 |
|
Over $100,000,000 |
| |
Decline to Disclose |
|
Decline to Disclose |
| |
Not Applicable |
|
Not Applicable |
6. Federal Exemption(s) and Exclusion(s) Claimed (select all that apply)
|
| |
Rule 504(b)(1) (not (i), (ii) or (iii)) |
|
| |
Rule 504 (b)(1)(i) |
|
| |
Rule 504 (b)(1)(ii) |
|
| |
Rule 504 (b)(1)(iii) |
|
| X |
Rule 506(b) |
|
| |
Rule 506(c) |
|
| |
Securities Act Section 4(a)(5) |
|
| |
Investment Company Act Section 3(c) |
|
| |
Section 3(c)(1) |
|
Section 3(c)(9) |
|
| |
Section 3(c)(2) |
|
Section 3(c)(10) |
|
| |
Section 3(c)(3) |
|
Section 3(c)(11) |
|
| |
Section 3(c)(4) |
|
Section 3(c)(12) |
|
| |
Section 3(c)(5) |
|
Section 3(c)(13) |
|
| |
Section 3(c)(6) |
|
Section 3(c)(14) |
|
|
|
7. Type of Filing
| |
New Notice |
|
Date of First Sale |
2021-08-06 |
|
|
First Sale Yet to Occur |
| X |
Amendment |
8. Duration of Offering
| Does the Issuer intend this offering to last more than one year? |
|
|
9. Type(s) of Securities Offered (select all that apply)
| X |
Equity |
|
Pooled Investment Fund Interests |
| |
Debt |
|
Tenant-in-Common Securities |
| |
Option, Warrant or Other Right to Acquire Another Security |
|
Mineral Property Securities |
| |
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? |
|
|
Clarification of Response (if Necessary):
11. Minimum Investment
| Minimum investment accepted from any outside investor |
$50,000
|
USD |
12. Sales Compensation
| Recipient |
| Recipient CRD Number |
X |
None |
|
| (Associated) Broker or Dealer |
X |
None |
|
| (Associated) Broker or Dealer CRD Number |
X |
None |
|
| Street Address 1 |
Street Address 2 |
| City |
State/Province/Country |
ZIP/Postal Code |
State(s) of Solicitation (select all that apply) Check “All States” or check individual States |
|
All States |
|
|
13. Offering and Sales Amounts
| Total Offering Amount |
|
USD |
|
| Total Amount Sold |
$2,825,000
|
USD |
| Total Remaining to be Sold |
|
USD |
|
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, and enter the 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 & Finder's 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 |
$0
|
USD |
|
| Finders' Fees |
$0
|
USD |
|
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.
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, in the accordance with applicable
law, 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 the issuer 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 |
Jon Massey |
Managing Partner |
2022-05-26 |
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.
* This undertaking does not affect any limits Section 102(a) of the National Securities Markets
Improvement Act of 1996 ("NSMIA") [Pub. L. No. 104-290, 110 Stat. 3416 (Oct. 11, 1996)] imposes on the ability of States to
require information. As a result, if the securities that are the subject of this Form D are "covered securities" for purposes
of NSMIA, whether in all instances or due to the nature of the offering that is the subject of this Form D, States cannot
routinely require offering materials under this undertaking or otherwise and can require offering materials only to the
extent NSMIA permits them to do so under NSMIA's preservation of their anti-fraud authority.