Sec Form 4 Filing - Mirman Abraham @ LILIS ENERGY, INC. - 2016-08-24

Insider filing report for Changes in Beneficial Ownership
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FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
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, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
Mirman Abraham
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
X __ Officer (give title below) _____ Other (specify below)
Chief Executive Officer
(Last) (First) (Middle)
216 16TH STREET, SUITE 1350
3. Date of Earliest Transaction (MM/DD/YY)
08/24/2016
(Street)
DENVER, CO80202
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 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
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 (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 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
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(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 of Derivative Security: 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
Series B 6% Convertible Preferred Stock ( 1 ) 08/24/2016 D 200 ( 2 ) ( 3 ) Common Stock 181,818 ( 4 ) 1,650 I ( 5 ) See footnote ( 5 )
Warrant (Right to Buy) $ 2.5 08/24/2016 D 90,909 ( 6 ) ( 7 ) ( 7 ) Common Stock 90,909 ( 4 ) 1 I ( 5 ) See footnote ( 5 )
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Mirman Abraham
216 16TH STREET, SUITE 1350
DENVER, CO80202
X Chief Executive Officer
Signatures
/s/ Ariella Fuchs, Attorney-In-Fact for Abraham Mirman 08/24/2016
Signature of Reporting Person Date
Explanation of Responses:
( 1 )The Series B 6% Convertible Preferred Stock is convertible into the issuer's common stock at a rate determined by dividing the stated value ($1,000) by $1.10.
( 2 )The Series B 6% Convertible Preferred Stock is exercisable immediately upon issuance, subject to certain conditions including the receipt of requisite stockholder approval pursuant to the Certificate of Designation.
( 3 )The Series B 6% Convertible Preferred Stock has no expiration date.
( 4 )The reporting person committed to purchase 1,850 shares of Series B 6% Convertible Preferred Stock and a warrant to purchase 8,409,091 shares of the issuer's common stock for an aggregate purchase price of $1,850,000, subsequent to which the Reporting Person transferred his commitment to purchase 200 shares of Series B 6% Convertible Preferred Stock to Mr. Kevin Nanke, the Issuer's Executive Vice President and Chief Financial Officer which resulted in the disposal of 200 shares of Series B 6% Convertible Preferred Stock and 90,909 shares of common stock underlying the warrant.
( 5 )The Bralina Group LLC, for which the Reporting Person has voting and dispositive control over the securities held by it.
( 6 )Represents underlying shares of common stock.
( 7 )The Warrant has a term of two years and exercisable immediately upon issuance, subject to certain conditions including the receipt of requisite stockholder approval pursuant to the Warrant.

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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