SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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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1. Name and Address of Reporting Person*
RUNNELS G TYLER

(Last) (First) (Middle)
1900 GRANT STREET, SUITE #720

(Street)
DENVER CO 80203

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
11/21/2014
3. Issuer Name and Ticker or Trading Symbol
LILIS ENERGY, INC. [ LLEX ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
5. 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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 866,414 I By Runnels Family Trust DTD 1-11-2000(1)
Common Stock 906,610 I By T.R. Winston & Company, LLC(2)
Common Stock 122,991 I By High Tide, LLC(3)
Common Stock 4,025 I By Pangaea Partners, LLC(4)
Common Stock 5,250 I By TRW Capital Management, LLC(5)
Common Stock 575,795 I By Golden Tiger, LLC(6)
Common Stock By SEP IRA Pershing LLC Custodian(7) 25 D
Common Stock By G. Tyler Runnels 401k(8) 15,000 D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Common Stock Warrant (right to buy) 05/28/2010 05/28/2015 Common Stock 16,667 $6 I By High Tide, LLC(3)
Common Stock Warrant (right to buy) 05/28/2010 05/28/2015 Common Stock 83,334 $6 I By Runnels Family Trust DTD 1-11-2000(1)
Common Stock Warrant (right to buy) 05/28/2010 05/28/2015 Common Stock 800,000 $6 I By T.R. Winston & Company, LLC(2)
Common Stock Warrant (right to buy) 05/28/2010 05/28/2015 Common Stock 83,400 $6 I By T.R. Winston & Company, LLC(2)
Common Stock Warrant (right to buy) 05/10/2013 05/10/2016 Common Stock 150,000 $4.25 I By T.R. Winston & Company, LLC(2)
Common Stock Warrant (right to buy) 06/27/2013 06/27/2016 Common Stock 650,000 $4.25 I By T.R. Winston & Company, LLC(2)
8% Senior Secured 2014 Convertible Debenture 01/31/2014 01/15/2015 Common Stock 427,164 $2 I By Runnels Family Trust DTD 1-11-2000(1)
Common Stock Warrant (right to buy) 07/23/2014 07/23/2017 Common Stock 86,125 $2.5 I By T.R. Winston & Company, LLC(2)
Common Stock Warrant (right to buy) 07/23/2014 07/23/2017 Common Stock 243,000 $2.5 I By T.R. Winston & Company, LLC(2)
Common Stock Warrant (right to buy) 08/01/2014 08/01/2017 Common Stock 85,480 $2.5 I By Runnels Family Trust DTD 1-11-2000(1)
Common Stock Warrant (right to buy) 08/01/2014 08/01/2017 Common Stock 203,423 $2.5 I By T.R. Winston & Company, LLC(2)
Common Stock Warrant (right to buy) 08/01/2014 08/01/2017 Common Stock 225,000 $2.5 I By T.R. Winston & Company, LLC(2)
Series A 8% Convertible Preferred Stock 09/16/2014 (9) Common Stock 529 (10) I By T.R. Winston & Company, LLC(2)
Series A 8% Convertible Preferred Stock 09/16/2014 (9) Common Stock 250 (10) I By Runnels Family Trust DTD 1-11-2000(1)
Common Stock Warrant (right to buy) 11/30/2014 11/30/2017 Common Stock 109,751 $2.89 I By T.R. Winston & Company, LLC(2)
Common Stock Warrant (right to buy) 11/30/2014 11/30/2017 Common Stock 51,868 $2.89 I By Runnels Family Trust DTD 1-11-2000(1)
Explanation of Responses:
1. Mr. Runnels, with Jasmine N. Runnels, is trustee of the Runnels Family Trust DTD 1-11-2000.
2. Mr. Runnels is the majority owner of T.R. Winston & Company, LLC.
3. Mr. Runnels is the manager of High Tide, LLC.
4. Mr. Runnels is the manager of Pangaea Partners, LLC.
5. Mr. Runnels is the chairman of TRW Capital Management, LLC.
6. Mr. Runnels is the manager of Golden Tiger, LLC.
7. The shares held by SEP IRA Pershing LLC Custodian are held for the account of Mr. Runnels.
8. The shares held by G. Tyler Runnels 401k are held for the account of Mr. Runnels.
9. The Series A 8% Convertible Preferred Stock has no expiration date.
10. The Series A 8% Convertible Preferred Stock is convertible into the issuer's common stock at a rate determined by dividing the stated value ($1,000) by $2.41.
Remarks:
Exhibit List: Exhibit 24.1 Power of Attorney
/s/ Eric Ulwelling, as attorney 12/05/2014
** 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 5 (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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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