UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 40-F
(Check One)
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Registration statement pursuant to Section 12 of the Securities Exchange Act of 1934
or
x
Annual report pursuant to Section 13(a) or 15(d) of the
Securities Exchange Act of 1934
For the fiscal year ended
December 31, 2016
Commission file number
1-35644
BELLATRIX EXPLORATION LTD.
(Exact name of registrant as specified in
its charter)
Alberta, Canada
(Province or other jurisdiction of incorporation or organization)
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1311
(Primary Standard Industrial
Classification Code Number (if applicable))
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None
(I.R.S. Employer
Identification Number (if Applicable))
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Suite 1920, 800 - 5th Avenue S.W., Calgary,
Alberta, Canada T2P 3T6
(403) 266-8670
(Address and Telephone Number of Registrant’s Principal Executive Offices)
Puglisi & Associates, 850 Library
Avenue, Suite 204, Newark, Delaware 19711
(302) 738-6680
(Name, Address (Including Zip Code) and Telephone Number
(Including Area Code) of Agent For Service in the United States)
Securities registered or to be registered
pursuant to Section 12(b) of the Act.
Title of each class
Common Shares
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Name of each exchange on which registered
New York Stock Exchange
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Securities registered or to be registered
pursuant to Section 12(g) of the Act.
None
Securities for which there is a reporting
obligation pursuant to Section 15(d) of the Act.
None
For annual reports, indicate by check mark
the information filed with this Form:
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x
Annual Information Form
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x
Audited Annual Financial Statements
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Indicate the number of outstanding shares of each of the issuer’s
classes of capital or common stock as of the close of the period covered by the annual report:
246,585,828
Indicate by check mark whether the registrant: (1) has filed
all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 (the “Exchange Act”)
during the preceding 12 months (or for such shorter period that the registrant was required to file such reports); and (2) has
been subject to such filing requirements for the past 90 days.
Indicate by check mark whether the registrant has submitted
electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant
to Rule 405 of Regulation S-T (s.232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant
was required to submit and post such files).
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FORM 40-F
Principal Documents
The following documents, filed as Exhibits 99.1, 99.2, 99.3
and 99.4 to this Annual Report on Form 40-F of Bellatrix Exploration Ltd. (“Bellatrix”), are hereby incorporated by
reference into this Annual Report on Form 40-F:
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(a)
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Annual Information Form for the fiscal year ended December 31, 2016;
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(b)
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Management’s Discussion and Analysis for the fiscal year ended December 31, 2016;
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(c)
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Audited Consolidated Financial Statements for the fiscal year ended December 31, 2016. Bellatrix’s Audited Consolidated
Financial Statements included in this Annual Report on Form 40-F have been prepared in accordance with International Financial
Reporting Standards, as issued by the International Accounting Standards Board. Therefore, they are not comparable in all respects
to financial statements of United States companies that are prepared in accordance with United States generally accepted accounting
principles; and
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(d)
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Supplementary Oil and Gas Information.
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ADDITIONAL DISCLOSURE
Certifications and Disclosure Regarding Controls and Procedures.
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(a)
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Certifications
. See Exhibits 99.5, 99.6, 99.7 and 99.8 to this Annual Report on Form 40-F.
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(b)
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Disclosure Controls and Procedures
. As of the end of Bellatrix’s fiscal year ended December 31, 2016, an evaluation
of the effectiveness of Bellatrix’s “disclosure controls and procedures” (as such term is defined in Rules 13a-15(e)
and 15d-15(e) of the Securities Exchange Act of 1934, as amended (the “Exchange Act”)) was carried out by Bellatrix’s
management, with the participation of its principal executive officer and principal financial officer. Based upon that evaluation,
Bellatrix’s principal executive officer and principal financial officer have concluded that as of the end of that fiscal
year, Bellatrix’s disclosure controls and procedures are effective to ensure that information required to be disclosed by
Bellatrix in reports that it files or submits under the Exchange Act is (i) recorded, processed, summarized and reported within
the time periods specified in Securities and Exchange Commission (the “Commission”) rules and forms and (ii) accumulated
and communicated to Bellatrix’s management, including its principal executive officer and principal financial officers, to
allow timely decisions regarding required disclosure.
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It should be noted that while Bellatrix’s principal
executive officer and principal financial officer believe that Bellatrix’s disclosure controls and procedures provide a reasonable
level of assurance that they are effective, they do not expect that Bellatrix’s disclosure controls and procedures or internal
control over financial reporting will prevent all errors and fraud. A control system, no matter how well conceived or operated,
can provide only reasonable, not absolute, assurance that the objectives of the control system are met.
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(c)
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Management’s Annual Report on Internal Control Over Financial Reporting
. The required disclosure is included under
the heading "Controls and Procedures - Management's Annual Report on Internal Control over Financial Reporting" in Bellatrix’s
Management Discussion and Analysis for the fiscal year ended December 31, 2016, filed as Exhibit 99.2 to this Annual Report on
Form 40-F.
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(d)
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Attestation Report of the Registered Public Accounting Firm
. The required disclosure is included in the “Independent
Auditor’s Report of Registered Public Accounting Firm” that accompanies Bellatrix’s Audited Consolidated Financial
Statements for the year ended December 31, 2016, filed as Exhibit 99.3 to this Annual Report on Form 40-F.
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(e)
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Changes in Internal Control Over Financial Reporting
. The required disclosure is included under the heading "Controls
and Procedures - Management's Annual Report on Internal Control over Financial Reporting" in Bellatrix’s Management
Discussion and Analysis for the fiscal year ended December 31, 2016, filed as Exhibit 99.2 to this Annual Report on Form 40-F.
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Notices Pursuant to Regulation
BTR.
None.
Audit Committee Financial Expert.
Bellatrix’s board of directors has determined that Keith
S. Turnbull, a member of Bellatrix’s audit committee, qualifies as an “audit committee financial expert” (as
such term is defined in Form 40-F) and is “independent” as that term is defined in the rules of the New York Stock
Exchange.
Code of Ethics
.
Bellatrix has adopted a “code of ethics” (as that
term is defined in Form 40-F), entitled the “Code of Business Conduct and Ethics” (the “Code of Ethics”),
that applies to its principal executive officer, principal financial officer, principal accounting officer or controller, and persons
performing similar functions.
The Code of Ethics is available for viewing on Bellatrix’s
website at
www.bellatrixexploration.com
, and is available in print, free of charge, to
any shareholder who requests it. Requests for copies of the Code of Ethics should be made by contacting: Bellatrix’s Investor
Relations Department at (403) 266 8670 or by e-mail at
investor.relations@bellatrixexploration.com.
Bellatrix intends to disclose and summarize any amendment to,
or waiver from, any provisions of the Code of Ethics that is required to be so disclosed and summarized, on its website at
www.bellatrixexploration.com.
Principal Accountant Fees
and Services.
The required disclosure is included under the heading “Audit
Committee Information−External Auditor Service Fees” in Bellatrix’s Annual Information Form for the fiscal year
ended December 31, 2016, filed as Exhibit 99.1 to this Annual Report on Form 40-F.
Pre-Approval Policies and
Procedures.
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(a)
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The required disclosure is included under the heading “Audit Committee Information−Pre-Approval Policies and Procedures”
in Bellatrix’s Annual Information Form for the fiscal year ended December 31, 2016, filed as Exhibit 99.1 to this Annual
Report on Form 40-F.
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(b)
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Of the fees reported under the heading “Audit Committee Information−External Auditor Service Fees” in Bellatrix’s
Annual Information Form for the fiscal year ended December 31, 2016, filed as Exhibit 99.1 to this Annual Report on Form 40-F,
none of the fees billed by KPMG LLP were approved by Bellatrix’s audit committee pursuant to the
de minimis
exception
provided by Section (c)(7)(i)(C) of Rule 2-01 of Regulation S-X.
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Off-Balance Sheet Arrangements.
The required disclosure is included under the heading “Off-Balance
Sheet Arrangements” in Bellatrix’s Management’s Discussion and Analysis for the fiscal year ended December 31,
2016, filed as Exhibit 99.2 to this Annual Report on Form 40-F.
Tabular Disclosure of Contractual Obligations.
The required disclosure is included under
the heading "Commitments" in Bellatrix’s Management’s Discussion and Analysis for the fiscal year ended December
31, 2016, filed as Exhibit 99.2 to this Annual Report on Form 40-F.
Identification of the Audit
Committee.
Bellatrix has a separately-designated standing audit committee
established in accordance with Section 3(a)(58)(A) of the Exchange Act. The members of the audit committee are: Keith S. Turnbull,
Keith Macdonald and Thomas E. MacInnis.
Mine Safety Disclosure.
Not applicable.
New York Stock Exchange Disclosure
Presiding Director at Meetings of Non-Management Directors
Bellatrix schedules regular executive sessions in which Bellatrix’s
“non-management directors” (as that term is defined in the rules of the New York Stock Exchange) meet without management
participation. Mr. W.C. (Mickey) Dunn serves as the presiding director (the “Presiding Director”) at such sessions.
Each of Bellatrix’s non-management directors is “independent” for the purposes of Canadian National Instrument
58-101 and the rules of the New York Stock Exchange.
Communication with Non-Management Directors
Shareholders may send communications to Bellatrix’s non-management
directors by writing to the Presiding Director, c/o Corporate Secretary, Bellatrix Exploration Ltd. Suite 1920, 800 5
th
Ave SW Calgary, Alberta, Canada T2P 3T6. Communications will be referred to the Presiding Director for appropriate action. The
status of all outstanding concerns addressed to the Presiding Director will be reported to the board of directors as appropriate.
According to Section 303A.09 of the NYSE Listed Company Manual,
a listed company must adopt and disclose a set of corporate governance guidelines with respect to specific topics. Such guidelines
are required to be posted on the listed company’s website. Bellatrix operates under corporate governance principles that
are consistent with the requirements of Section 303A.09 of the NYSE Listed Company Manual, and which are described under the heading
“Statement of Corporate Governance Practices” in Bellatrix’s Information Circular prepared in connection with
its annual meetings of shareholders. However, Bellatrix has not codified its corporate governance principles into formal guidelines
for posting on its website.
Board Committee Mandates
The Mandates of Bellatrix’s audit committee, compensation
committee, and corporate governance committee are each available for viewing on Bellatrix’s website at
www.bellatrixexploration.com.
NYSE Statement of Governance Differences
As a Canadian corporation listed on the New York Stock Exchange,
Bellatrix is not required to comply with most of the NYSE’s corporate governance standards, so long as it complies with Canadian
and Toronto Stock Exchange corporate governance requirements. In order to claim such an exemption, however, Bellatrix must disclose
the significant difference between its corporate governance practices and those required to be followed by U.S. domestic companies
under the New York Stock Exchange’s corporate governance standards.
Bellatrix has prepared a summary of the significant ways in
which its corporate governance practices differ from those required to be followed by U.S. domestic companies under the New York
Stock Exchange’s corporate governance standards, and that summary, entitled “Significant Differences in Bellatrix’s
Corporate Governance Practices Compared to NYSE Corporate Governance Standards”, is available for viewing on Bellatrix’s
website at www.bellatrixexploration.com.
Bellatrix’s corporate governance practices meet or exceed
all applicable Canadian requirements. They also incorporate some best practices derived from the New York Stock Exchange rules
and comply with applicable United States securities laws and rules adopted by the Commission. Further information about Bellatrix’s
corporate governance practices is included under the heading “Statement of Corporate Governance Practices” in Bellatrix’s
Information Circular prepared in respect of its annual meetings of shareholders.
UNDERTAKING AND CONSENT TO SERVICE OF
PROCESS
A. Undertaking.
Bellatrix undertakes to make available,
in person or by telephone, representatives to respond to inquiries made by the Commission staff, and to furnish promptly, when
requested to do so by the Commission staff, information relating to: the securities registered pursuant to Form 40-F; the securities
in relation to which the obligation to file an annual report on Form 40-F arises; or transactions in said securities.
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B.
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Consent to Service of Process.
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Bellatrix has previously filed a Form F-X
in connection with the class of securities in relation to which the obligation to file this report arises.
Any change to the name or address of the
agent for service of process of Bellatrix shall be communicated promptly to the Commission by an amendment to the Form F-X referencing
the file number of Bellatrix.
SIGNATURES
Pursuant to the requirements of the Exchange
Act, the registrant certifies that it meets all of the requirements for filing on Form 40-F and has duly caused this annual report
to be signed on its behalf by the undersigned, thereunto duly authorized, on March 17, 2017.
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BELLATRIX EXPLORATION LTD.
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/s/ Edward J. Brown
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Name:
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Edward J. Brown
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Title:
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Executive Vice-President, Finance and Chief Financial Officer
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EXHIBIT INDEX
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Exhibit
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Description
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99.1
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Annual Information Form for the fiscal year ended December 31, 2016
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99.2
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Management’s Discussion and Analysis for the fiscal year ended December 31, 2016
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99.3
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Audited Consolidated Financial Statements for the fiscal year ended December 31, 2016, prepared in accordance with International Financial Reporting Standards, as issued by the International Accounting Standards Board
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99.4
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Supplementary Oil and Gas Information
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99.5
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Certification of Chief Executive Officer pursuant to Rule 13a-14 or 15d-14 of the Securities Exchange Act of 1934
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99.6
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Certification of Chief Financial Officer pursuant to Rule 13a-14 or 15d-14 of the Securities Exchange Act of 1934
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99.7
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Certification of Chief Executive Officer pursuant to 18 U.S.C. Section 1350
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99.8
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Certification of Chief Financial Officer pursuant to 18 U.S.C. Section 1350
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99.9
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Consent of KPMG LLP
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99.10
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Consent of InSite Petroleum Consultants
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