SEC Form 4/A · accession 0001683692-16-000015
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
Sep 28, 2016
Accepted (ET)
Oct 4, 2016 · 5:08 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 28, 2016 | S | 23,955 | $3.40 | D | 110,650 | D | |
| Common StockF2,F3 | Sep 28, 2016 | S | 57,000 | $3.30 | D | 1,628,646 | I | See Footnote 3 |
| Common StockF4,F3 | Sep 28, 2016 | S | 2,300 | $3.36 | D | 1,626,346 | I | See Footnote 3 |
| Common StockF3 | Sep 28, 2016 | S | 2,403 | $3.50 | D | 1,623,943 | I | See Footnote 3 |
| Common StockF3 | Sep 29, 2016 | S | 52,340 | $3.50 | D | 1,571,603 | 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 in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $3.30 to $3.312 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 in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $3.36 to $3.368 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 the holder to acquire common stock at a price per share that is less than $25.00
Remarks
The box on the previously filed Form 4 on September 30, 2016, was inadvertently checked to state that the Reporting Person was no longer subject to Section 16. This amendment is being filed solely to state that the Reporting Person is still subject to Section 16 reporting. All transactions reported herein are the same as those reported on the Form 4 filed on September 30, 2016. Ex 24 - Power of Attorney Filed on September 9, 2016