SEC Form 4 · accession 0001144204-17-024945
LILIS ENERGY, INC. · LLEX
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Ronald D Ormand
Officer — Executive Chairman · Director
Period of report
May 3, 2017
Accepted (ET)
May 5, 2017 · 8:21 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 | May 3, 2017 | J | 149,000 | — | A | 3,678,086 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Warrant (right to buy)F1,F2 | $2.50 | May 3, 2017 | J | 68,182 | A | Jun 22, 2016 | Jun 22, 2018 | Common Stock | 68,182 | 522,728 | I |
Explanation of responses
- F1The securities were originally acquired using borrowed funds. The securities are being transferred to the Reporting Person in lieu of repayment pursuant to the terms of such borrowing arrangement.
- F2These securities are held by Perugia Investments L.P. Reporting Person is the manager of Perugia and has sole voting and dispositive power over the securities held by Perugia.