SEC Form 4/A · accession 0001144204-17-034206
LILIS ENERGY, INC. · LLEX
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 4/A). It replaces an earlier filing for the same period.
Reporting owner
Abraham Mirman
Officer — Chief Executive Officer · Director
Period of report
Jun 16, 2017
Accepted (ET)
Jun 26, 2017 · 9:48 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 | Jun 16, 2017 | F | 53,942 | — | D | 2,494,041 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (Right to Buy)F2 | $1.34 | Jun 16, 2017 | D | 250,000 | D | Jun 24, 2016 | Jun 24, 2026 | Common Stock | 250,000 | 1,000,000 | D |
| Stock Option (Right to Buy)F2 | $2.98 | Jun 16, 2017 | D | 500,000 | D | Dec 15, 2016 | Dec 15, 2026 | Common Stock | 500,000 | 0 | D |
Explanation of responses
- F1This forfeiture, which was inadvertently omitted from the Original Form 4, was undertaken solely to satisfy tax withholding liabilities relating to the vesting of restricted share awards held by the Reporting Person. The Reporting Person made the withholding election on June 16, 2017 with respect to restricted shares that vested on June 16, 2017. The aggregate value of the common shares so withheld was based on the closing price of the common shares on the NYSE MKT on the vesting date, which was $5.31.
- F2The Original Form 4 listed the incorrect transaction date, which was June 9, 2016. The correct transaction date is June 16, 2017.
- F3This transaction involves the partial rescission of a prior grant of 1,250,000 stock options granted to the Reporting Person on June 24, 2016, 250,000 of which were in excess of the limits authorized by the Plan.
- F4This transaction involves the rescission of a prior grant of 500,000 stock options granted to the Reporting Person on December 15, 2016, all of which were in excess of the limits authorized by the Plan.
Remarks
The filing of this Form 4/A is to correct the disclosure contained in the Form 4 filed on June 16, 2017 (the "Original Form 4"). The Original Form 4 stated the incorrect earliest transaction date, which should have been June 16, 2017, instead of June 9, 2017.