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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*
Heckman Thomas J

(Last) (First) (Middle)
15612 COLLEGE BLVD.

(Street)
LENEXA KS 66219

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
05/05/2023
3. Issuer Name and Ticker or Trading Symbol
AMERICAN NOBLE GAS, INC. [ AMNI ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
X Officer (give title below) Other (specify below)
CEO & CFO
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 2,500,000 D
Common Stock 449,306 I Through Ozark Capital, LLC(1)
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 06/04/2021 06/04/2031 Common stock 500,000 $0.5 D
Stock Option 05/30/2013 05/30/2023 Common stock 2,000 $3 D
Warrant to purchase common stock 09/26/2021 09/26/2026 Common stock 256,410 $0.05 I Through Ozark Capital, LLC(1)
Warrant to purchase common stock 11/05/2023 11/05/2029 Common stock 5,000,000 $0.05 I Through Ozark Capital, LLC(1)
Series A Convertible Preferred Stock 03/26/2021 (2) Common stock 347,188 $0.05 I Through Ozark Capital, LLC(1)
Series B Convertible Preferred Stock 05/05/2023 (2) Common stock 5,000,000 $0.05 I Through Ozark Capital, LLC(1)
Explanation of Responses:
1. Reporting Person controls and owns Ozark Capital, LLC which is the owner of these shares and/or warrants.
2. The Company's Series A and B Convertible Preferred Stock has no expiration or redemption date.
Thomas J. Heckman 05/09/2023
** 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.