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*
Mills Drake

(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
X Officer (give title below) Other (specify below)
Chairman, President and CEO
3. Date of Earliest Transaction (Month/Day/Year)
12/13/2022
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 132,102 D
Common Stock 3,466 I By IRA
Common Stock 51,752 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
Restricted Stock Units (1) 12/13/2022 A 129,736 (2) (2) Common Stock 129,736 $0 129,736 D
Performance Stock Units (3) 12/13/2022 A 129,735 (4) (4) Common Stock 129,735 $0 129,735 D
Restricted Stock Units (5) (5) (5) Common Stock 4,667 4,667(5) D
Restricted Stock Units (6) (6) (6) Common Stock 8,252 8,252(6) D
Explanation of Responses:
1. 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.
2. These restricted stock units will vest twenty percent on each of the third, fourth, fifth, sixth and seventh anniversaries of the grant date, starting with the first vest date of December 13, 2025, and settle as soon as administratively possible following the applicable vesting date, but in any event within 30 days thereof.
3. Each performance 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.
4. The performance stock units ("PSUs") are eligible to vest based on achievement of five pre-established stock price hurdles (each, a "Stock Price Hurdle") during a seven-year performance period beginning on December 13, 2022. Each of the five tranches of PSUs will vest on the later of the date that the applicable Stock Price Hurdle is achieved or the third, fourth, fifth, sixth and seventh anniversaries of the grant date.
5. Granted on February 18, 2022, vesting ratably over three years with the first vest date of February 18, 2023.
6. Granted on August 20, 2021, vesting ratably over three years with the first vest date of August 19, 2022.
Remarks:
/s/ Drake Mills 12/13/2022
** 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.
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.