SEC Form 4/A · accession 0001683692-16-000005
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
Period of report
Jun 23, 2016
Accepted (ET)
Sep 2, 2016 · 3:37 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 | |
| Common StockF1,F2,F3,F4 | Jun 23, 2016 | J | 1,863,946 | — | A | 2,106,118 | I | See Footnotes 2,3,4 |
| Common StockF5,F2,F3,F6 | Aug 30, 2016 | S | 5,000 | $3.0045 | D | 2,101,118 | I | See Footnotes 2,3,6 |
| Common StockF5,F2,F3,F7 | Aug 30, 2016 | S | 15,526 | $3.00 | D | 2,085,582 | I | See Footnotes 2,3,7 |
| Common StockF5,F2,F3,F8 | Aug 30, 2016 | S | 19,596 | $3.10 | D | 2,065,996 | I | See Footnotes 2,3,8 |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WarrantF3,F9 | $25.00 | Jun 23, 2016 | J | 200,000 | A | Jun 23, 2016 | Jun 23, 2018 | Common Stock | 200,000 | 200,000 | I |
Explanation of responses
- F1On 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.
- F2This represents shares of Issuer common stock held by the reporting person Sean O'Sullivan Revocable Living Trust. The natural person with ultimate voting control or investment control over the shares of common stock held by Sean O'Sullivan Revocable Living Trust is Sean O'Sullivan.
- F3This represents shares of Issuer common stock held by SOSV Investments LLC f/k/a SOSventures LLC. The natural person with ultimate voting control or investment control over the shares of common stock held by SOSV Investments LLC is Sean O'Sullivan, who is also the natural person with ultimate voting control or investment control over the reporting person.
- F4This represents 242,172 share of Issuer common stock held by the reporting person and 1,863,946 shares of Issuer common stock held by SOSV Investments LLC f/k/a SOSVentures LLC.
- F5The common stock shares were sold by the reporting person.
- F6This represents 237,172 share of Issuer common stock held by the reporting person and 1,863,946 shares of Issuer common stock held by SOSV Investments LLC f/k/a SOSVentures LLC.
- F7This represents 221,646 share of Issuer common stock held by the reporting person and 1,863,946 shares of Issuer common stock held by SOSV Investments LLC f/k/a SOSVentures LLC.
- F8This represents 202,050 share of Issuer common stock held by the reporting person and 1,863,946 shares of Issuer common stock held by SOSV Investments LLC f/k/a SOSVentures LLC.
- F9The exercise price is subject to downward adjustment if, prior to nine months after June 23, 2016, the Issuer issues warrants in a capital raising transaction that entitle the holder to acquire common stock at a price per share that is less than $25.00.