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*
Crowther Elizabeth Hinton

(Last) (First) (Middle)
17 WEST MAIN STREET

(Street)
LURAY VA 22835

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
BLUE RIDGE BANKSHARES, INC. [ BRBS ]
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)
01/31/2021
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 01/31/2021 A 4,321 A (1) 4,321 D
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 Option (right to buy) $21 01/31/2021 A 289 01/31/2021 12/07/2027 Common Stock 289 (2) 289 D
Stock Option (right to buy) $17 01/31/2021 A 500 01/31/2021 05/20/2029 Common Stock 500 (3) 500 D
Explanation of Responses:
1. Received in exchange for 8,642 shares of Bay Banks of Virginia, Inc. ("Bay Banks") common stock in connection with the merger of Bay Banks with and into Blue Ridge Bankshares, Inc. ("Blue Ridge") effective January 31, 2021 (the "Merger"). At the effective time of the Merger at 7:00 p.m. on January 31, 2021 (the "Effective Time"), each outstanding share of common stock of Bay Banks converted into the right to receive 0.5000 shares of Blue Ridge common stock. On January 29, 2021, the last trading day before the Effective Time, the closing price of Bay Banks' common stock was $9.50 per share and the closing price of Blue Ridge's common stock was $18.83 per share. All fractional share holdings were paid in cash.
2. Received in the Merger in exchange for stock options to acquire 579 shares of Bay Banks common stock for $10.35 per share.
3. Received in the Merger in exchange for stock options to acquire 1,000 shares of Bay Banks common stock for $8.08 per share.
Remarks:
/s/ Amanda G. Story, attorney-in-fact 02/02/2021
** 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 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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