SEC Form 4/A · accession 0001213900-16-012481
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
Ronald D Ormand
Director
Period of report
Jan 5, 2016
Accepted (ET)
Apr 13, 2016 · 6:31 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,F2 | $0.50 | Jan 5, 2016 | P | 1,150,000 | A | Jan 5, 2016 | — | Common Stock | 2,300,000 | 2,300,000 | I |
| Warrant (Right to Buy)F1,F3 | $0.25 | Jan 5, 2016 | P | 4,600,000 | A | Jan 5, 2016 | Jan 5, 2019 | Common Stock | 4,600,000 | 4,600,000 | I |
Explanation of responses
- F1The amount of the investment and the entity named as the direct beneficial owner was reported erroneously in the reporting person's original Form 4. The total purchase price and amount of securities has been adjusted accordingly.
- F2Includes the principal amount but does not account for interest. The Subordinated Convertible Note (the "Note") accrues interest at a rate of 12% per annum and matures on June 30, 2016. The outstanding principal and accrued interest on the Note can be converted at any time prior to repayment of the Note.
- F3A warrant to purchase 4,600,000 shares of common stock was issued by the Company as additional consideration for the purchase price of the Note.