SEC Form 4 · accession 0001213900-16-014502
LILIS ENERGY, INC. · LLEX
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Nuno Brandolini
Director
Period of report
Jun 23, 2016
Accepted (ET)
Jun 27, 2016 · 8:00 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 StockF2,F1 | Jun 23, 2016 | C | 20,000 | — | A | 110,621 | D | |
| Common StockF2,F3 | Jun 23, 2016 | C | 227,273 | — | A | 337,894 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series A 8% Convertible Preferred StockF1,F2 | — | Jun 23, 2016 | C | 100 | D | — | — | Common Stock | 20,000 | 0 | D |
| Subordinated Convertible NoteF3,F2 | — | Jun 23, 2016 | C | — | D | — | — | Common Stock | 227,273 | 0 | D |
Explanation of responses
- F1The Series A 8% Convertible Preferred Stock converted into Lilis Energy, Inc. common stock at $5.00 and had no expiration date.
- F2All share amounts that appear in this report have been adjusted to reflect a 1-for-10 reverse stock split of Lilis Energy, Inc.'s outstanding common stock effected on June 23, 2016.
- F3The Subordinated Convertible Notes held by the Reporting Person were converted in full into Lilis Energy, Inc. common stock at $1.10 on June 23, 2016 and was set to mature on June 30, 2016.