0000899243-16-031574.txt : 20161011 0000899243-16-031574.hdr.sgml : 20161011 20161011180009 ACCESSION NUMBER: 0000899243-16-031574 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161011 FILED AS OF DATE: 20161011 DATE AS OF CHANGE: 20161011 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Yorktown X Associates LLC CENTRAL INDEX KEY: 0001687161 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37907 FILM NUMBER: 161932054 BUSINESS ADDRESS: STREET 1: 410 PARK AVENUE STREET 2: 19TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10022 BUSINESS PHONE: 2125152100 MAIL ADDRESS: STREET 1: 410 PARK AVENUE STREET 2: 19TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10022 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2016-10-11 0 0001655020 Extraction Oil & Gas, Inc. XOG 0001687161 Yorktown X Associates LLC 410 PARK AVENUE, 19TH FLOOR NEW YORK NY 10022 0 0 1 0 Common Stock, par value $0.01 per share 108460231 I See Footnotes These securities are owned directly by Extraction Oil & Gas Holdings, LLC ("Holdings"). Yorktown Energy Partners IX, L.P. ("Yorktown IX"), Yorktown Energy Partners X, L.P. ("Yorktown X"), Yorktown Energy Partners XI, L.P. ("Yorktown XI") and YT Extraction Co Investment Partners, LP ("YT Co Invest" and together with Yorktown IX, Yorktown X and Yorktown XI, collectively, the "Yorktown Funds") share the right to appoint a majority of the representatives to the board of managers of Holdings. As a result, the Yorktown Funds may be deemed to share the power to vote or direct the vote or to dispose or direct the disposition of the common stock owned by Holdings. Yorktown X Associates LLC ("Yorktown X Associates") is the sole general partner of Yorktown X Company LP, the sole general partner of Yorktown X. Yorktown X Associates disclaims beneficial ownership of these securities except to the extent of its pecuniary interest therein, and this report shall not be deemed an admission that Yorktown X Associates is the beneficial owner of the securities for Section 16 or any other purpose. A number of shares of common stock of Extraction Oil & Gas, Inc. ("XOG") will be issued to Yorktown X after the closing of the initial public offering of XOG (the "offering") based on (i) Yorktown X's equity ownership in Holdings, an entity which will merge with and into XOG in connection with the closing of the offering, and (ii) the 10-day volume weighted average price of XOG's common stock following the closing of the offering. Yorktown X Associates is the sole general partner of Yorktown X Company LP, the sole general partner of Yorktown X. Yorktown X Associates LLC, /s/ Peter A. Leidel, Manager 2016-10-11