0001655020-18-000042.txt : 20180323 0001655020-18-000042.hdr.sgml : 20180323 20180323163430 ACCESSION NUMBER: 0001655020-18-000042 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161017 FILED AS OF DATE: 20180323 DATE AS OF CHANGE: 20180323 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: O'Brien Patrick Dennis CENTRAL INDEX KEY: 0001685912 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-37907 FILM NUMBER: 18710507 MAIL ADDRESS: STREET 1: 370 17TH STREET STREET 2: SUITE 5300 CITY: DENVER STATE: CO ZIP: 80202 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 5300 CITY: DENVER STATE: CO ZIP: 80202 BUSINESS PHONE: (720) 557-8300 MAIL ADDRESS: STREET 1: 370 17TH STREET STREET 2: SUITE 5300 CITY: DENVER STATE: CO ZIP: 80202 FORMER COMPANY: FORMER CONFORMED NAME: Extraction Oil & Gas, LLC DATE OF NAME CHANGE: 20151007 4/A 1 wf-form4a_152183725668863.xml FORM 4/A X0306 4/A 2016-10-17 2016-10-19 0 0001655020 Extraction Oil & Gas, Inc. XOG 0001685912 O'Brien Patrick Dennis 370 17TH STREET SUITE 5300 DENVER CO 80202 1 0 0 0 COMMON STOCK 2016-10-17 4 A 0 75000 0 A 75000 D COMMON STOCK 2016-10-17 4 A 0 7000 19 A 82000 D Represents an award of 75,000 unvested restricted stock units, which vest on October 17, 2017, subject to continued service through the vesting date, and will be settled in shares of common stock. These shares were purchased by the reporting person pursuant to the directed share program as part of the Company's initial public offering. The report on Form 4 filed on October 19, 2016 inadvertently omitted these shares. These shares were also omitted from two subsequently filed Form 4s. /s/ Eric J. Christ, as Attorney-in-Fact 2018-03-23