| FORM 4 | 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 or Section 30(h) of the Investment Company Act of 1940 |
| |||||||||||||||
| Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). | |||||||||||||||||
1. Name and Address of Reporting Person*
(Street)
| 2. Issuer Name and Ticker or Trading Symbol DEEP WELL OIL & GAS INC [ DWOG ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| ||||||||||||||||||||||||
| 3. Date of Earliest Transaction (Month/Day/Year) 09/19/2019 | ||||||||||||||||||||||||||
| 4. If Amendment, Date of Original Filed (Month/Day/Year) | 6. Individual or Joint/Group Filing (Check Applicable Line)
| |||||||||||||||||||||||||
| Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 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 (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 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 (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (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: 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 | ||||||||
| Stock Option (Expired) | $0.38 | 09/19/2019 | J(1) | 600,000(1) | (1) | 09/19/2019 | Common Stock | 600,000(1) | $0.38 | 1,200,000(1) | D | ||||
| Stock Option (Expired) | $0.38 | 09/19/2019 | J(2) | 1,200,000(2) | (2) | 09/19/2019 | Common Stock | 1,200,000(2) | $0.38 | 0(2)(3) | I | See footnote(4) | |||
| Explanation of Responses: |
| 1. On September 19, 2014, the Issuer's Board granted the Reporting Person, options to purchase 600,000 shares each of common stock at an exercise price of $0.38 per common share, with one-third vesting immediately, one-third vesting on September 19, 2015, and one-third vesting on September 19, 2016, each with a five-year life from the original grant date. The Reporting Person has not exercised any of these outstanding options. These options have now expired unexercised. |
| 2. On September 19, 2014, the Issuer's Board granted Concorde Consulting, options to purchase 1,200,000 shares of common stock at an exercise price of $0.38 per common share, with one-half vesting immediately and one-half vesting on September 19, 2015, with a five-year life from the original grant date. Concorde Consulting has not exercised any of these outstanding options. These options have now expired unexercised. |
| 3. As of September 19, 2019, the Reporting Person beneficially owns 1,978,571 shares (non-derivative securities) of the Issuer's common stock, of which (i) 600,000 shares are held directly; and (ii) 1,378,571 shares are held indirectly by Concorde Consulting. |
| 4. Concorde Consulting is a company owned 100% by the Reporting Person, providing consulting services as Chief Financial Officer to the Issuer. |
| /s/ Curtis Sparrow | 09/20/2019 | |
| ** 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 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). | ||
| Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
| Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. | ||
