SEC Form 4 · accession 0001144204-18-004725

LILIS ENERGY, INC. · LLEX

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Officer — Chief Operating Officer

Period of report

Jan 27, 2018

Accepted (ET)

Jan 30, 2018 · 7:53 pm EST

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 Stock^F1	Jan 27, 2018	F	7,114	—	D	418,180	D

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Stock Option (Right to Buy)^F2,F3	$4.48	Jan 30, 2018	A	50,000	A	—	May 2, 2027	Common Stock	50,000	300,000	D

F1This forfeiture 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 January 27, 2018 with respect to restricted shares that vested on January 27, 2018. The aggregate value of the common shares so withheld was based on the closing price of the common shares on the NYSE American on January 26, 2018 (the last trading day immediately prior to the vesting date), which was $4.50.
F2Represents options to purchase common stock granted by Lilis Energy, Inc. ("Lilis") pursuant to the 2016 Omnibus Incentive Plan. The Reporting Person was granted an option to purchase 500,000 shares of common stock on May 2, 2017, 250,000 of which vested immediately, and 250,000 of which vests upon Lilis achieving specific performance criteria, subject to continued service up to each vesting date. The performance criteria for one installment was met, resulting in the vesting of the option as to 50,000 shares.
F3This option to purchase common stock expires ten years from the grant date.