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