Lori Sirman Form 4 Origin Bancorp / Lori Sirman ownership change

SEC Form 4

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

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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^*

Sirman Lori

(Last) (First) (Middle)

500 SOUTH SERVICE ROAD EAST

(Street)

RUSTON LA 71270

(City) (State) (Zip)

2. Issuer Name and Ticker or Trading Symbol
Origin Bancorp, Inc. [ OBNK ]

5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	10% Owner
	Officer (give title below)	Other (specify below)

3. Date of Earliest Transaction (Month/Day/Year)
11/07/2022

4. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

X	Form filed by One Reporting Person
	Form filed by More than One Reporting Person

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
Common Stock	11/07/2022		M		23,173	A	$15.11	78,105	D
Common Stock	11/07/2022		M		1,324	A	$15.11	79,429	D
Common Stock								8,829	I	By IRA
Common Stock								21,248	I	By KSOP
Common Stock								277	I	BY ISSUER RETIREMENT PLAN

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 Options (Right to Buy)	$15.11	11/07/2022		M			23,173	(1)	01/22/2023	Common Stock	23,173	$0	0	D
Stock Options (Right to Buy)	$15.11	11/07/2022		M			1,324	(1)	12/16/2023	Common Stock	1,324	$0	0	D
Stock Options (Right to Buy)	$19.64							(1)	12/15/2024	Common Stock	2,751		2,751	D
Stock Options (Right to Buy)	$19.64							(1)	12/21/2025	Common Stock	5,674		5,674	D
Stock Options (Right to Buy)	$22.28							(1)	06/20/2026	Common Stock	6,621		6,621	D
Stock Options (Right to Buy)	$23.64							(1)	12/19/2026	Common Stock	4,568		4,568	D
Stock Options (Right to Buy)	$31.72							(1)	12/18/2027	Common Stock	18,538		18,538	D
Stock Options (Right to Buy)	$37.01							(1)	12/18/2028	Common Stock	16,552		16,552	D
Stock Options (Right to Buy)	$37.76							(1)	12/16/2029	Common Stock	23,173		23,173	D
Stock Options (Right to Buy)	$33.23							(1)	02/16/2031	Common Stock	23,173		23,173	D

Explanation of Responses:

1. Pursuant to the Merger Agreement, at the effective time of the Merger, August 1, 2022, each outstanding and unexercised option to purchase shares of BTH common stock became fully vested and automatically converted into an option to purchase shares of issuer common stock, with the number of underlying shares and the exercise price determined as set forth in the Merger Agreement. Each option to purchase shares of issuer common stock is subject to the same terms and conditions (excluding vesting but including exercisability terms) as the corresponding option to purchase shares of BTH common stock immediately prior to the effective time of the Merger.

Remarks:

	/s/ Drake Mills, as Attorney-in-Fact	11/08/2022
	** 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.
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