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*
Farmar Richard A III

(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)
07/01/2021
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 07/01/2021 A(1) 1,333(2) A $17.93 41,417(3) 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) $7(4) 01/31/2021 02/21/2023 Common Stock 3,750 3,750(5) D
Stock Option (right to buy) $7.99(6) 01/31/2021 03/28/2024 Common Stock 750 750(7) D
Stock Option (right to buy) $7.16(8) 01/31/2021 02/10/2025 Common Stock 750 750(9) D
Stock Option (right to buy) $7.68(10) 01/31/2021 01/22/2026 Common Stock 750 750(11) D
Stock Option (right to buy) $11.07(12) 01/31/2021 02/21/2027 Common Stock 750 750(13) D
Stock Option (right to buy) $13.8(14) 01/31/2021 12/07/2027 Common Stock 1,183 1,183(15) D
Stock Option (right to buy) $10.77(16) 01/31/2021 05/20/2029 Common Stock 750 750(17) D
Explanation of Responses:
1. Stock received in lieu of cash compensation
2. Restricted stock subject to a vesting schedule.
3. 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 13,361 shares of the Company's common stock as of April 20, 2021.
4. This option was previously reported as an option for 2,500 shares of common stock at an exercise price of $10.50, but was adjusted to reflect the stock split declared by the Company on March 17, 2021.
5. As a result of the stock split declared by the Company on March 17, 2021, the reporting person received 1,250 shares of the Company's common stock as of April 20, 2021. At the same time, pursuant to anti-dilution provisions of the Company's equity compensation plans, an option for 3,750 shares of common stock held by the reporting person on April 20, 2021 became exercisable for 375 shares of common stock.
6. This option was previously reported as an option for 500 shares of common stock at an exercise price of $11.98, but was adjusted to reflect the stock split declared by the Company on March 17, 2021.
7. As a result of the stock split declared by the Company on March 17, 2021, the reporting person received 250 shares of the Company's common stock as of April 20, 2021. At the same time, pursuant to anti-dilution provisions of the Company's equity compensation plans, an option for 750 shares of common stock held by the reporting person on April 20, 2021 became exercisable for 750 shares of common stock.
8. This option was previously reported as an option for 500 shares of common stock at an exercise price of $10.74, but was adjusted to reflect the stock split declared by the Company on March 17, 2021.
9. As a result of the stock split declared by the Company on March 17, 2021, the reporting person received 250 shares of the Company's common stock as of April 20, 2021. At the same time, pursuant to anti-dilution provisions of the Company's equity compensation plans, an option for 750 shares of common stock held by the reporting person on April 20, 2021 became exercisable for 750 shares of common stock.
10. This option was previously reported as an option for 500 shares of common stock at an exercise price of $11.52, but was adjusted to reflect the stock split declared by the Company on March 17, 2021.
11. As a result of the stock split declared by the Company on March 17, 2021, the reporting person received 250 shares of the Company's common stock as of April 20, 2021. At the same time, pursuant to anti-dilution provisions of the Company's equity compensation plans, an option for 750 shares of common stock held by the reporting person on April 20, 2021 became exercisable for 750 shares of common stock.
12. This option was previously reported as an option for 500 shares of common stock at an exercise price of $16.60, but was adjusted to reflect the stock split declared by the Company on March 17, 2021.
13. As a result of the stock split declared by the Company on March 17, 2021, the reporting person received 250 shares of the Company's common stock as of April 20, 2021. At the same time, pursuant to anti-dilution provisions of the Company's equity compensation plans, an option for 750 shares of common stock held by the reporting person on April 20, 2021 became exercisable for 750 shares of common stock.
14. This option was previously reported as an option for 789 shares of common stock at an exercise price of $20.70, but was adjusted to reflect the stock split declared by the Company on March 17, 2021.
15. As a result of the stock split declared by the Company on March 17, 2021, the reporting person received 394 shares of the Company's common stock as of April 20, 2021. At the same time, pursuant to anti-dilution provisions of the Company's equity compensation plans, an option for 1,183 shares of common stock held by the reporting person on April 20, 2021 became exercisable for 1,183 shares of common stock.
16. This option was previously reported as an option for 500 shares of common stock at an exercise price of $16.16, but was adjusted to reflect the stock split declared by the Company on March 17, 2021.
17. As a result of the stock split declared by the Company on March 17, 2021, the reporting person received 250 shares of the Company's common stock as of April 20, 2021. At the same time, pursuant to anti-dilution provisions of the Company's equity compensation plans, an option for 750 shares of common stock held by the reporting person on April 20, 2021 became exercisable for 750 shares of common stock.
/s/ Richard A. Farmer III 11/02/2021
** Signature of Reporting Person Date
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* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
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