UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | SEC 1473 (7-02) | ||
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 control number. |
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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
BATES THOMAS R JR 11 GREENWAY PLAZA, SUITE 2950 HOUSTON, TX 77046 |
 X |  |  |  |
/s/ Steven A. Manz, attorney-in-fact | 10/26/2005 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | To be converted into 13,762,700 shares of common stock, par value $0.01 per share, of Hercules Offshore, Inc. in the conversion of the Company from a limited liability company to a corporation prior to the closing of the Company's initial public offering. |
(2) | Consists of the membership interests owned by LR Hercules Holdings, LP. Mr. Bates is a member of LR2 GP, LLC, which controls the investment decisions of LR Hercules Holdings, LP. Mr. Bates disclaims ownership of the membership interests held by LR Hercules Holdings, LP except to the extent of his pecuniary interest therein, and this report shall not be deemed an admission that Mr. Bates is the beneficial owner of the securities for purposes of Section 16 or for any other purpose. |
 Remarks: Exhibit List Exhibit 24 Power of Attorney |