U.S. SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 4 OMB APPROVAL ----------------------------- [_] Check this box if no longer OMB NUMBER: 3235-0287 subject to Section 16. Form 4 Expires: September 30, 1998 or Form 5 obligations may Estimated average burden continue. SEE Instruction 1(b). hours per response ...... 0.5 ----------------------------- STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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(f) of the Investment Company Act of 1940 1. Name and Address of Reporting Person* BSR INVESTMENTS, LTD. - -------------------------------------------------------------------------------- (Last) (First) (Middle) c/o HARNEY, WESTWOOD & RIEGELS BOX 71 - -------------------------------------------------------------------------------- (Street) CRAIGMUIR CHAMBERS, ROAD TOWN, TORTOLA, B.V.I. - -------------------------------------------------------------------------------- (City) (State) (Zip) - -------------------------------------------------------------------------------- 2. Issuer Name and Ticker or Trading Symbol CHENIERE ENERGY, INC. (CHEX) - -------------------------------------------------------------------------------- 3. IRS or Social Security Number of Reporting Person (Voluntary) - -------------------------------------------------------------------------------- 4. Statement for Month/Year 12/97 - -------------------------------------------------------------------------------- 5. If Amendment, Date of Original (Month/Year) - -------------------------------------------------------------------------------- 6. Relationship of Reporting Person to Issuer (Check all applicable) Director X 10% Owner ----- ------ Officer (give Other (Specify ----- title below) ------ below) ---------------------------------- 7. Individual or Joint/Group Filing (Check Applicable Line) X Form filed by One Reporting Person - ---- Form filed by More than One Reporting Person - ---- - --------------------------------------------------------------------------------
Table 1 -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned 1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Ownership 7. Nature (Instr. 3) action action or Disposed of (D) Securities Form: of Indirect Date Code Beneficially Direct Beneficial (Instr. 8) (Instr. 3, 4 and 5) Owned at (D) or Ownership (Month/ ------------ -------------------------- End of Month Indirect (Instr. 4) Day/ Code V Amount (A) or Price (Instr. 3 (I) Year) (D) and 4) (Instr. 4) - -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ ------------- - -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ ------------- - -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ ------------- - -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ ------------- - -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ ------------- - -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Print or Type Responses) (Over) SEC 1474 (7-96) ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ FORM 4 (continued)
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) 1. Title of Derivative Security 2. Conversion 3. Transaction 4. Transacation 5. Number of Derivative 6. Date Exercisable (Instr. 3) or Exercise Date Code Securities Acquired (A) and Expiration Price of (Month/Day/ (Instr. 8) or Disposed of (D) Date Derivative Year) (Instr. 3, 4, and 5) (Month/Day/ Security Year) --------------- -------------------------- ------------------- Code V (A) (D) Date Expiration Exer- Date cisable - ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ---------- STOCK WARRANT $2.375 12/18/97 P 166,667 12/18/97 12/31/01 - ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ---------- - ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ---------- - ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ---------- - ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ---------- - ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
7. Title and Amount of 8. Price of Derivative 9. Number of Derivative 10. Ownership Form 11. Nature of Indirect Underlying Securities Security (Instr. 5) Securities Beneficially of Derivative Security: Beneficial Ownership (Instr. 3 and 4) Owned at End of Month Direct (D) or (Instr. 4) (Instr. 4) Indirect (I) (Instr. 4) - ------------------------ Title Amount or Number of Shares - ------------------------ ---------------------- -------------------------- --------------------------- ------------------------ COMMON STOCK 166,667 (1) 166,667 D - ------------------------ ---------------------- -------------------------- --------------------------- ------------------------ - ------------------------ ---------------------- -------------------------- --------------------------- ------------------------ - ------------------------ ---------------------- -------------------------- --------------------------- ------------------------ - ------------------------ ---------------------- -------------------------- --------------------------- ------------------------ - ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
Explanation of Responses: (1) The warrant was issued as additional consideration for a $2,000,000 term loan evidenced by a promissory note for such amount. **Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). /S/ NICOLE SOUKI January 9, 1998 _______________________________ ______________ **Signature of Reporting Person Date Secretary, on behalf of BSR Investments, Ltd. Note: File three copies of this Form, one of which must be manually signed. If space provided is insufficient, See Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. Page 2 SEC 1474 (7-96)