SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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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1. Name and Address of Reporting Person*
Blosser Michael W

(Last) (First) (Middle)
414 UNION STREET

(Street)
NASHVILLE TN 37219

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
12/01/2021
3. Issuer Name and Ticker or Trading Symbol
LOUISIANA-PACIFIC CORP [ LPX ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
SVP, Manufacturing Services
5. 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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 203,424(1) D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Settled Stock Appreciation Right (2) (2) Common Stock 9,349 $18.09 D
Stock Settled Stock Appreciation Right (2) (2) Common Stock 7,500 $17.04 D
Stock Settled Stock Appreciation Right (2) (2) Common Stock 10,944 $15.74 D
Stock Settled Stock Appreciation Right (2) (2) Common Stock 6,493 $19.14 D
Explanation of Responses:
1. Awards granted pursuant to Louisiana-Pacific 2013 Omnibus Plan. An award of 6,006 Restricted Stock Units ("RSUs") was granted on February 7, 2019 and vests in full on February 7, 2022. An award of 4,316 RSUs was granted on February 6, 2020, of which one third vested on the first anniversary of the grant date, one third vests on the second anniversary of the grant date, and one third vests on the third anniversary of the grant date. An award of 4,133 RSUs was granted on February 12, 2021 and vests one third on each of the anniversaries of the grant date. RSUs convert into Common Stock on a one-for-one basis as of the date of vesting. RSUs earn dividends in equivalent shares
2. Awards granted pursuant to Louisiana-Pacific 2013 Omnibus Plan. Each award of Stock Settled Stock Appreciation Rights ("SSARs") was fully vested prior to the date on which the Reporting Person became subject to Section 16. SSARs expire ten years from the grant date
Remarks:
/s/Nicole Daniel, Attorney-in-Fact 12/10/2021
** 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 5 (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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