SEC Form 4/A · accession 0001179110-17-007914
Extraction Oil & Gas, Inc. · XOG
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
John Shepherd Gaensbauer
Director
Period of report
Oct 26, 2016
Accepted (ET)
May 24, 2017 · 4:12 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 | 40,422 | $0.00 | A | 77,922 | D | |
| Common StockF2 | Oct 26, 2016 | A | 70,019 | $0.00 | A | 70,019 | I | See note (2) |
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.
- F2Pursuant to the transactions described in footnote (1) to the reporting person's original Form 4 filed on October 28, 2016, Sierra Partners LLC received 70,019 shares of common stock. Mr. Gaensbauer is a partner at Sierra Partners LLC. The report on Form 4 filed on October 28, 2016 inadvertently omitted these shares. These shares were also omitted from one subsequently filed Form 4.