SEC Form 4 · accession 0001683692-16-000003
LILIS ENERGY, INC. · LLEX
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
A later amendment supersedes this filing — read the amendment. The figures below are kept as originally reported (version chain, not an overwrite).
Reporting owner
Period of report
Jun 23, 2016
Accepted (ET)
Sep 1, 2016 · 9:55 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,F2 | Jun 23, 2016 | J | 242,172 | — | A | 242,172 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1All 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 effect on June 23, 2016.
- F2On June 23, 2016, pursuant to an Agreement and Plan of Merger, dated December 29, 2015 (the "Merger Agreement"), as amended on January 20, 2016, March 24, 2016 and June 22, 2016,
by and among Lilis Energy, Inc. ("Issuer"), Lilis Merger Sub, Inc., a wholly owned subsidiary of Issuer ("Merger Sub"), and Brushy Resources, Inc. ("Brushy"), Merger sub merged with and into Brushy,
with Brushy continuing as the surviving entity and a wholly owned subsidiary of the Issuer (the "Merger"). As result of the Merger, the shares of Brushy common stock were exchanged for shares of 
Issuer common stock at a ratio of 0.4550916 shares of Issuer common stock for every one share of Brushy common stock. This represents shares of Brushy common stock that were exchanged for shares
of Issuer common stock in connection with the Merger.