SEC FORM
4
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
|
| OMB APPROVAL |
| OMB Number: |
3235-0287 |
| Estimated average burden |
| hours per response: |
0.5 |
|
|
 |
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*
| LAKELAND FINANCIAL CORPORATION |
| P.O. BOX 1387 |
(Street)
|
2. Issuer Name and Ticker or Trading Symbol
LAKELAND FINANCIAL CORP
[ LKFN ]
|
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)
07/13/2021
|
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 |
07/13/2021 |
|
A |
|
650 |
A |
$0
|
26,235 |
D |
|
| Common Stock |
|
|
|
|
|
|
|
26,668 |
I |
As trustee |
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 |
| Phantom Stock |
|
|
|
|
|
|
|
|
|
Common Stock |
15,985 |
|
15,985 |
D |
|
| Explanation of Responses: |
|
|
|
|
/s/ Becka J. Turnbow, Attorney-in-Fact |
07/15/2021 |
|
** 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). |
| 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. |
LAKELAND FINANCIAL CORPORATION
POWER OF ATTORNEY
SECTIONS 13d AND 16a MATTERS
Know all by these present the undersigned hereby
constitutes and appoints each of Becka J. Turnbow,
Matthew VanDeWielle and J. Rickard Donovan, signing
singly, as the undersigneds true and lawful attorneys in fact
to
1 execute for and on behalf of the undersigned,
in the undersigneds capacity as a more than five percent
5 percent stockholder if applicable of Lakeland Financial
Corporation the Company, any Schedule 13D or
Schedule 13G and any amendments thereto in accordance
with Section 13d of the Securities Exchange Act of
1934 the Exchange Act and the rules thereunder
2 execute for and on behalf of the undersigned,
in the undersigneds capacity as a director, officer
or stockholder of the Company or a subsidiary of the
Company, Forms 3, 4 and 5 in accordance with Section
16a of the Exchange Act and the rules thereunder
3 do and perform any and all acts for and on
behalf of the undersigned which may be necessary
or desirable to complete and execute any such Form 3,
4 or 5 and any such Schedule 13D or Schedule 13G and
any amendments thereto and timely file such form or
schedule with the United States Securities and Exchange
Commission, the Nasdaq Stock Market, the Company and
any stock exchange or similar authority and
4 take any other action of any type whatsoever
in connection with the foregoing which, in the opinion
of such attorney in fact, may be of benefit to, in the
best interest of, or legally required by, the undersigned,
it being understood that the documents executed by
such attorney in fact on behalf of the undersigned
pursuant to this Power of Attorney shall be in
such form and shall contain such terms and conditions
as such attorney in fact may approve in such
attorney in facts discretion.
The undersigned hereby grants to each such attorney in fact
full power and authority to do and perform any and
every act and thing whatsoever requisite, necessary
or proper to be done in the exercise of any of the
rights and powers herein granted, as fully to all
intents and purposes as the undersigned might or
could do if personally present, with full power
or substitution or revocation, hereby ratifying
and confirming all that such attorney in fact, or
such attorney in facts substitute or substitutes,
shall lawfully do or cause to be done by virtue
of this power of attorney and the rights and
powers herein granted. The undersigned acknowledges
that the foregoing attorneys in fact, in serving in
such capacity at the request of the undersigned,
are not assuming, nor is the Company assuming, any
of the undersigneds responsibilities to comply
with Section 13d or Section 16 of the Exchange Act.
This Power of Attorney shall remain in full force
and effect until the undersigned is no longer required
to file Forms 3, 4 and 5 and Schedule 13D or Schedule
13G including any amendments thereto with respect
to the undersigneds holdings of and transactions
in securities issued by the Company, unless earlier
revoked by the undersigned in a signed writing
delivered to the foregoing attorneys in fact.
IN WITNESS WHEREOF, the undersigned has caused
this Power of Attorney to be executed as of the
13th day of July, 2021.
s Brian J Smith
Name
