0001655020-20-000058.txt : 20200403 0001655020-20-000058.hdr.sgml : 20200403 20200403144955 ACCESSION NUMBER: 0001655020-20-000058 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200401 FILED AS OF DATE: 20200403 DATE AS OF CHANGE: 20200403 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Owens Matthew R CENTRAL INDEX KEY: 0001685843 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37907 FILM NUMBER: 20772937 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 1 wf-form4_158593977631422.xml FORM 4 X0306 4 2020-04-01 0 0001655020 Extraction Oil & Gas, Inc. XOG 0001685843 Owens Matthew R 370 17TH STREET SUITE 5300 DENVER CO 80202 1 1 0 0 President & CEO COMMON STOCK 2020-04-01 4 F 0 7779 0.359 D 1364437 D COMMON STOCK 1837755 I See Footnote (2) These shares represent amounts withheld by the Issuer to satisfy the Reporting Person's tax withholding obligations These shares are owned by OFI Properties, LLC, of which Mr. Owens holds 100% of the managing interest. The Matthew R. Owens 2016 Grantor Retained Annuity Trust, of which Mr. Owens is Trustee, owns a 75% non-managing interest in OFI Properties, LLC. /s/ Eric J. Christ as Attorney-in-Fact 2020-04-02