SEC Form 4 · accession 0001104659-16-153043
Extraction Oil & Gas, Inc. · XOG
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
Mark Erickson
Officer — Chairman and CEO · Director
Period of report
Oct 26, 2016
Accepted (ET)
Oct 28, 2016 · 7:30 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001655020
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common stockF1 | Oct 26, 2016 | A | 4,636,810 | — | A | 5,136,810 | D | |
| Common stockF1,F2 | Oct 26, 2016 | A | 81 | — | A | 81 | I | See Footnote |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1These shares of common stock of Extraction Oil & Gas, Inc. ("XOG") were received by the reporting person in connection with the merger of Extraction Oil & Gas Holdings, LLC ("Holdings") with and into XOG in connection with the closing of the initial public offering of XOG, pursuant to which the reporting person's equity ownership (including outstanding incentive units and restricted units) in Holdings were exchanged for shares of common stock in XOG determined by reference to XOG's implied valuation based on the 10-day volume weighted average price of XOG's common stock following the beginning of trading of XOG's common stock, in accordance with the distribution mechanics set forth in the limited liability company agreement of Holdings.
- F2These shares are owned by MAE Holdings 2011 LLC. MAE Holdings 2011 LLC is an entity owned by Mr. Erickson.