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