0001171843-16-013776.txt : 20161223 0001171843-16-013776.hdr.sgml : 20161223 20161223181732 ACCESSION NUMBER: 0001171843-16-013776 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161219 FILED AS OF DATE: 20161223 DATE AS OF CHANGE: 20161223 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: SYNTHESIS ENERGY SYSTEMS INC CENTRAL INDEX KEY: 0001375063 STANDARD INDUSTRIAL CLASSIFICATION: MISCELLANEOUS PRODUCTS OF PETROLEUM & COAL [2990] IRS NUMBER: 202110031 STATE OF INCORPORATION: DE FISCAL YEAR END: 0630 BUSINESS ADDRESS: STREET 1: THREE RIVERWAY, SUITE 300 CITY: HOUSTON STATE: TX ZIP: 77056 BUSINESS PHONE: 713-579-0600 MAIL ADDRESS: STREET 1: THREE RIVERWAY, SUITE 300 CITY: HOUSTON STATE: TX ZIP: 77056 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Raczkowski Chris CENTRAL INDEX KEY: 0001693184 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33522 FILM NUMBER: 162069524 MAIL ADDRESS: STREET 1: C/O SYNTHESIS ENERGY SYSTEMS, INC. STREET 2: THREE RIVERWAY, SUITE 300 CITY: HOUSTON STATE: TX ZIP: 77056 3 1 f3_raczkowski122216.xml OWNERSHIP DOCUMENT X0206 3 2016-12-19 0 0001375063 SYNTHESIS ENERGY SYSTEMS INC SYMX 0001693184 Raczkowski Chris THREE RIVERWAY, SUITE 300 HOUSTON TX 77056 0 1 0 0 President - Asia Common Stock 213232 D Stock Option (right to buy) 0.89 2026-12-16 Common Stock 282971 D This option vests in four equal quarterly installments beginning on March 31, 2017. /s/ Scott Davis 2016-12-23