0001171843-17-003272.txt : 20170523 0001171843-17-003272.hdr.sgml : 20170523 20170523161547 ACCESSION NUMBER: 0001171843-17-003272 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170517 FILED AS OF DATE: 20170523 DATE AS OF CHANGE: 20170523 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: SYNTHESIS ENERGY SYSTEMS INC CENTRAL INDEX KEY: 0001375063 STANDARD INDUSTRIAL CLASSIFICATION: MISCELLANEOUS PRODUCTS OF PETROLEUM & COAL [2990] IRS NUMBER: 202110031 STATE OF INCORPORATION: DE FISCAL YEAR END: 0630 BUSINESS ADDRESS: STREET 1: THREE RIVERWAY, SUITE 300 CITY: HOUSTON STATE: TX ZIP: 77056 BUSINESS PHONE: 713-579-0600 MAIL ADDRESS: STREET 1: THREE RIVERWAY, SUITE 300 CITY: HOUSTON STATE: TX ZIP: 77056 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Raczkowski Chris CENTRAL INDEX KEY: 0001693184 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33522 FILM NUMBER: 17863904 MAIL ADDRESS: STREET 1: C/O SYNTHESIS ENERGY SYSTEMS, INC. STREET 2: THREE RIVERWAY, SUITE 300 CITY: HOUSTON STATE: TX ZIP: 77056 4 1 formfour.xml OWNERSHIP DOCUMENT X0306 4 2017-05-17 0 0001375063 SYNTHESIS ENERGY SYSTEMS INC SYMX 0001693184 Raczkowski Chris THREE RIVERWAY, SUITE 300 HOUSTON TX 77056 0 1 0 0 President - Asia Stock Option (right to buy) 0.82 2017-05-17 4 A 0 135832 0 A 2027-05-01 Common Stock 135832 135832 D This option was issued to the reporting person in lieu of $64,833 of base salary earned for the period from May 1, 2017 to October 31, 2017. /s/ Chris Raczkowski 2017-05-23