SEC Form 4 · accession 0001413507-15-000055
SRC Energy Inc. · SRCI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
James P Henderson
Officer — CFO
Period of report
Aug 24, 2015
Accepted (ET)
Dec 21, 2015 · 4:10 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001413507
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Aug 24, 2015 | A | 75,000 | $0.00 | A | 75,000 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Non-Qualified Stock OptionF3,F2 | $10.01 | Dec 16, 2015 | A | 150,000 | A | Dec 17, 2015 | Dec 16, 2025 | Commom Stock | 150,000 | 150,000 | D |
Explanation of responses
- F1Shares to vest in five equal annual installments.
- F2Options to vest in five equal annual installments.
- F3The stock option grant reported on Mr. Henderson's Form 3 filed on August 31, 2015 did not occur. The grant reported herein is the anticipated grant to Mr. Henderson referenced in the issuer's current report of Form 8-K filed on August 25, 2015.