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