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. [ OBK ]

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)
08/18/2023

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	08/18/2023		M		2,226	A	(1)	81,655	D
Common Stock	08/18/2023		F(2)		526	D	$31.02	81,129	D
Common Stock								23,013(3)	I	BY ISSUER RETIREMENT PLAN
Common Stock								8,829	I	By IRA

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
Restricted Stock Units	(1)	08/18/2023		M			2,226	(4)	(4)	Common Stock	2,226	$0	4,452(4)	D
Restricted Stock Units	(5)							(6)	(6)	Common Stock	2,233		2,233(6)	D
Stock Options (Right to Buy)	$19.64							(7)	12/15/2024	Common Stock	2,751		2,751	D
Stock Options (Right to Buy)	$19.64							(7)	12/21/2025	Common Stock	5,674		5,674	D
Stock Options (Right to Buy)	$22.28							(7)	06/20/2026	Common Stock	6,621		6,621	D
Stock Options (Right to Buy)	$33.23							(7)	02/16/2031	Common Stock	23,173		23,173	D
Stock Options (Right to Buy)	$31.72							(7)	12/18/2027	Common Stock	18,538		18,538	D
Stock Options (Right to Buy)	$37.76							(7)	12/16/2029	Common Stock	23,173		23,173	D
Stock Options (Right to Buy)	$23.64							(7)	12/19/2026	Common Stock	4,568		4,568	D
Stock Options (Right to Buy)	$37.01							(7)	12/18/2028	Common Stock	16,552		16,552	D

Explanation of Responses:

1. Restricted stock units convert into common stock on a one-for-one basis.

2. Represents the number of common stock that have been withheld by the issuer to satisfy its income tax withholding and remittance obligations in connection with the net settlement of the restricted stock units and does not represent a sale.

3. On February 27, 2023, total 21,248 shares that were held under KSOP rolled over to issuer's retirement plan.

4. Granted on February 17, 2023, with 2,226 shares vesting on each of the vesting dates of August 18, 2023, August 19, 2024, and August 19, 2025.

5. Each restricted stock unit represents the contingent right to receive, at settlement, one share of the issuer's common stock or cash equal to the fair value thereof (calculated pursuant to the incentive agreement), as determined by the issuer.

6. Granted on February 17, 2023, vesting ratably over three years with the first vest date of February 17, 2024.

7. 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	08/22/2023
	** 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).
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