0001655020-21-000226.txt : 20211029 0001655020-21-000226.hdr.sgml : 20211029 20211029212549 ACCESSION NUMBER: 0001655020-21-000226 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211027 FILED AS OF DATE: 20211029 DATE AS OF CHANGE: 20211029 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Tyree Thomas B JR CENTRAL INDEX KEY: 0001309347 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37907 FILM NUMBER: 211365097 MAIL ADDRESS: STREET 1: 410 - 17TH STREET STREET 2: SUITE 1400 CITY: DENVER STATE: CO ZIP: 80202 FORMER NAME: FORMER CONFORMED NAME: Tyree Thomas B DATE OF NAME CHANGE: 20041122 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 5200 CITY: DENVER STATE: CO ZIP: 80202 BUSINESS PHONE: (720) 557-8300 MAIL ADDRESS: STREET 1: 370 17TH STREET STREET 2: SUITE 5200 CITY: DENVER STATE: CO ZIP: 80202 FORMER COMPANY: FORMER CONFORMED NAME: Extraction Oil & Gas, LLC DATE OF NAME CHANGE: 20151007 4 1 wf-form4_163555713229840.xml FORM 4 X0306 4 2021-10-27 1 0001655020 Extraction Oil & Gas, Inc. XOG 0001309347 Tyree Thomas B JR 370 17TH STREET, SUITE 5200 DENVER CO 80202 1 1 0 0 Chief Executive Officer COMMON STOCK 2021-10-27 4 A 0 108000 A 126000 D COMMON STOCK 2021-10-27 4 F 0 55416 69.23 D 70504 D Performance Stock Unit 2021-10-27 4 D 0 54000 0 D COMMON STOCK 108000.0 0 D Vesting of the Performance Stock Units was accelerated in full, with settlement on a two for one basis, in connection with the reporting person's termination from employment. The reported securities include 18,000 shares of common stock received in respect of restricted stock units granted on January 20, 2021 and previously reported in Table I, for which vesting was accelerated in full in connection with the reporting person's termination from employment. /s/ Eric J. Christ as Attorney-in-Fact 2021-10-29