0001655020-21-000081.txt : 20210122
0001655020-21-000081.hdr.sgml : 20210122
20210122194030
ACCESSION NUMBER: 0001655020-21-000081
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210120
FILED AS OF DATE: 20210122
DATE AS OF CHANGE: 20210122
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Willard Howard A.
CENTRAL INDEX KEY: 0001431004
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37907
FILM NUMBER: 21547501
MAIL ADDRESS:
STREET 1: 6601 WEST BROAD STREET
CITY: RICHMOND
STATE: VA
ZIP: 23230
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Extraction Oil & Gas, Inc.
CENTRAL INDEX KEY: 0001655020
STANDARD INDUSTRIAL CLASSIFICATION: CRUDE PETROLEUM & NATURAL GAS [1311]
IRS NUMBER: 461473923
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 370 17TH STREET
STREET 2: SUITE 5200
CITY: DENVER
STATE: CO
ZIP: 80202
BUSINESS PHONE: (720) 557-8300
MAIL ADDRESS:
STREET 1: 370 17TH STREET
STREET 2: SUITE 5200
CITY: DENVER
STATE: CO
ZIP: 80202
FORMER COMPANY:
FORMER CONFORMED NAME: Extraction Oil & Gas, LLC
DATE OF NAME CHANGE: 20151007
4
1
wf-form4_161136241739241.xml
FORM 4
X0306
4
2021-01-20
0
0001655020
Extraction Oil & Gas, Inc.
XOG
0001431004
Willard Howard A.
C/O EXTRACTION OIL & GAS, INC.
370 17TH STREET, SUITE #5200
DENVER
CO
80202
1
0
0
0
Deferred Stock Unit
2021-01-20
4
A
0
16800
A
COMMON STOCK
16800.0
16800
D
Represents an award to the Reporting Person of 16,800 deferred stock units ("DSUs"). The DSUs will vest in quarterly installments over a twelve (12) month period following the grant date and will become fully vested on the twelve month anniversary of the grant date. The DSUs will be settled in shares of common stock of Extraction Oil and Gas, Inc. upon the Reporting Person's separation of service.
/s/ Eric J. Christ as Attorney-in-Fact
2021-01-22