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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1. Name and Address of Reporting Person*
Harrell Curtis F.

(Last) (First) (Middle)
2001 KIRBY DRIVE, SUITE 200

(Street)
HOUSTON TX 77019

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
01/18/2018
3. Issuer Name and Ticker or Trading Symbol
Nine Energy Service, Inc. [ NINE ]
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 of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 4,654 D
Common Stock 400(1) D
Common Stock 56 I By Harrell Ventures, LLC(2)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (right to buy) (3) 07/07/2024 Common Stock 189 $264.48 D
Stock Option (right to buy) (4) 06/01/2025 Common Stock 188 $264.48 D
Stock Option (right to buy) (5) 06/01/2026 Common Stock 295 $169.27 D
Explanation of Responses:
1. These shares of restricted stock will vest on March 20, 2020.
2. Represents 56 shares of common stock held by Harrell Ventures LLC, of which Mr. Harrell is the sole member.
3. Of these stock options, 142 are currently exercisable, and the remaining 47 stock options will become exercisable on July 7, 2018.
4. Of these stock options, 94 are currently exercisable, and the remaining 94 stock options will become exercisable as to 1/2 on June 1, 2018 and as to 1/2 on June 1, 2019.
5. Of these stock options, 74 are currently exercisable, and the remaining 221 stock options will become exercisable as to 1/3 on June 1, 2018, 1/3 on June 1, 2019 and 1/3 on June 1, 2020.
Remarks:
This Form 3 is being filed in connection with the effectiveness of the Registration Statement on Form S-1 (Registration No. 333-217601) of Nine Energy Service, Inc. See attached for Exhibit 24 - Power of Attorney.
/s/ Curtis F. Harrell by Theodore R. Moore, as Attorney-in-fact 01/18/2018
** 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.
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