0001567619-21-016090.txt : 20210819 0001567619-21-016090.hdr.sgml : 20210819 20210819093136 ACCESSION NUMBER: 0001567619-21-016090 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210701 FILED AS OF DATE: 20210819 DATE AS OF CHANGE: 20210819 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Holzwarth Andrew C. CENTRAL INDEX KEY: 0001796438 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39165 FILM NUMBER: 211188607 MAIL ADDRESS: STREET 1: 17 WEST MAIN STREET CITY: LURAY STATE: VA ZIP: 22835 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BLUE RIDGE BANKSHARES, INC. CENTRAL INDEX KEY: 0000842717 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] IRS NUMBER: 541470908 STATE OF INCORPORATION: VA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 17 WEST MAIN STREET CITY: LURAY STATE: VA ZIP: 22835 BUSINESS PHONE: 540-843-5207 MAIL ADDRESS: STREET 1: 17 WEST MAIN STREET CITY: LURAY STATE: VA ZIP: 22835 FORMER COMPANY: FORMER CONFORMED NAME: BLUE RIDGE BANKSHARES INC DATE OF NAME CHANGE: 19881115 4 1 doc1.xml FORM 4 X0306 4 2021-07-01 0 0000842717 BLUE RIDGE BANKSHARES, INC. BRBS 0001796438 Holzwarth Andrew C. 17 WEST MAIN STREET LURAY VA 22835 1 0 0 0 Common Stock 2021-07-01 4 A 0 1333 17.93 A 106003 D Common Stock 7882 I By UTMA Account - Andrew Ward Holzwarth Common Stock 0 I By UTMA Account - Michael Anthony Holzwarth Stock received in lieu of cash compensation Restricted stock subject to a vesting schedule. On March 17, 2021, Blue Ridge Bankshares, Inc., (the "Company") declared a three-for-two stock split effected in the form of a 50% stock dividend on its common stock outstanding to shareholders of record as of April 20, 2021. As a result, the reporting person received 34,890 shares of the Company's common stock as of April 20, 2021. At the same time, 2,627 shares were allocated to the UTMA Account for Andrew Ward Holzwarth. The reporting person is no longer the Trustee of the UTMA Account for Michael Anthony Holzwarth and therefore no longer has any beneficial ownership of the 7,882 shares held. /s/ Amanda G. Story, Attorney-In-Fact 2021-08-19