SEC Form 4 · accession 0001683692-16-000013
LILIS ENERGY, INC. · LLEX
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Period of report
Sep 23, 2016
Accepted (ET)
Sep 27, 2016 · 4:27 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 | Sep 23, 2016 | S | 15,545 | $3.40 | D | 134,605 | D | |
| Common StockF2,F3 | Sep 23, 2016 | S | 4,600 | $3.31 | D | 1,691,746 | I | See Footnote 3 |
| Common StockF4,F3 | Sep 26, 2016 | S | 6,100 | $3.30 | D | 1,685,646 | I | See Footnote 3 |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WarrantF3,F5 | $25.00 | holding | — | — | — | Jun 23, 2016 | Jun 23, 2018 | Common Stock | 200,000 | 200,000 | I |
Explanation of responses
- F1This 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.
- F2The reported price is a weighted average price. These shares were sold in multiple transactions at prices ranging from $3.30 to $3.35 per share, inclusive. The reporting person undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote.
- 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.
- F4The reported price is a weighted average price. These shares were sold in multiple transactions at prices ranging from $3.30 to $3.31 per share, inclusive. The reporting person undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote.
- F5The 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 a holder to acquire common stock at a price per share that is less than $25.00
Remarks
Ex 21 - Power of Attorney executed as of September 9, 2016 and previously filed with the commission.