SEC Form 4 · accession 0001213900-16-011798
LILIS ENERGY, INC. · LLEX
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
R Glenn Dawson
Director
Period of report
Mar 18, 2016
Accepted (ET)
Mar 22, 2016 · 9:24 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001437557
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Subordinated Convertible NoteF1 | $0.50 | Jan 18, 2016 | P | — | A | Mar 18, 2016 | — | Common Stock | 100,000 | 100,000 | D |
| Warrant (Right to Buy)F2 | $0.25 | Jan 18, 2016 | P | 200,000 | A | Mar 18, 2016 | Mar 18, 2019 | Common Stock | 200,000 | 200,000 | D |
Explanation of responses
- F1The Subordinated Convertible Note (the "Note") accrues interest at a rate of 12% per annum and matures on April 1, 2017. The outstanding principal and accrued interest on the Note can be converted at any time, subject to stockholder approval prior to repayment of the Note.
- F2A warrant to purchase 200,000 shares of common stock was issued by the Company as additional consideration for the purchase price of the Note.