SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
BENZ PETER

(Last) (First) (Middle)
216 16TH STREET, SUITE 1350

(Street)
DENVER CO 80202

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
LILIS ENERGY, INC. [ LLEX ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
06/23/2016
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock(1) 06/23/2016 A 45,510 A (2) 45,510 D
Common Stock(1) 06/23/2016 A 341,553 A (2) 387,063 I See Footnotes(3)(6)
Common Stock(1) 06/23/2016 A 399,096 A (2) 786,159 I See Footnotes(4)(6)
Common Stock(1) 06/23/2016 A 249,075 A (2) 1,035,234 I See Footnotes(5)(6)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Explanation of Responses:
1. All share amounts that appear in this report have been adjusted to reflect a 1-for-10 reverse stock split of Lilis Energy, Inc.'s outstanding common stock effected on June 23, 2016.
2. On June 23, 2016, pursuant to an Agreement and Plan of Merger, dated as of December 29, 2015, as amended on January 20, 2016, March 24, 2016 and June 22, 2016, by and among Lilis Energy, Inc. ("Issuer"), Lilis Merger Sub, Inc., a wholly owned subsidiary of Issuer ("Merger Sub"), and Brushy Resources, Inc. ("Brushy"), Merger Sub merged with and into Brushy, with Brushy continuing as the surviving entity and a wholly owned subsidiary of the Issuer (the "Merger"). As a result of the Merger, the shares of Brushy common stock were exchanged for shares of Issuer common stock at a ratio of 0.4550916 shares of Issuer common stock for every one share of Brushy common stock. This represents shares of Brushy common stock that were exchanged for shares of Issuer common stock in connection with the Merger.
3. This represents shares of Issuer common stock held by LMIF Investments, LLC ("LMIF"). The natural persons with ultimate voting or investment control over the shares of common stock held by LMIF are the reporting person, S. Michael Rudolph and Merrick Okamoto. As a result, the reporting person may be deemed to have voting or investment control over these shares.
4. This represents shares of Issuer common stock held by Longview Marquis Master Fund, L.P. ("Longview"). The natural persons with ultimate voting or investment control over the shares of common stock held by Longview are the reporting person, S. Michael Rudolph and Merrick Okamoto. As a result, the reporting person may be deemed to have voting or investment control over these shares.
5. This represents shares of Issuer common stock held by SMF Investments, LLC ("SMF"). The natural persons with ultimate voting or investment control over the shares of common stock held by SMF are the reporting person, S. Michael Rudolph and Merrick Okamoto. As a result, the reporting person may be deemed to have voting or investment control over these shares.
6. The reporting person disclaims beneficial ownership of the securities reported herein except to the extent of his pecuniary interest therein. The filing of this statement shall not be deemed to be an admission that, for purposes of Section 16 of the Securities Exchange Act of 1934 or otherwise, the reporting person is the beneficial owners of any securities reported herein.
/s/ Peter Benz 06/27/2016
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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