SEC Form 4 · accession 0001144204-17-022802
LILIS ENERGY, INC. · LLEX
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Abraham Mirman
Officer — Chief Executive Officer · Director
Period of report
Apr 25, 2017
Accepted (ET)
Apr 27, 2017 · 9:29 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001437557
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Apr 25, 2017 | C | 1,639,000 | — | A | 2,401,906 | I | See Footnote |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series B 6% Convertible Preferred StockF2,F1 | — | Apr 25, 2017 | C | 1,650 | D | — | — | Common Stock | 1,639,000 | 0 | I |
Explanation of responses
- F1The Series B 6% Convertible Preferred Stock were converted in full into Lilis Energy, Inc. common stock at a conversion price of $1.10 and takes into account the increased stated value due to accrued and cumulative dividends. Such Preferred Stock had no expiration date.
- F2These securities are held by The Bralina Group, LLC. Reporting Person has shared voting and dispositive power over the securities held by The Bralina Group, LLC with Susan Mirman.