# EDGAR Filing Document

**Accession Number:** 0001339736
**File Stem:** 0001062993-23-004752
**Filing Date:** 2023-2
**Character Count:** 7216
**Document Hash:** d2c07308c6d25d8b0d512a402f56bdbc
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001062993-23-004752.hdr.sgml**: 20230224

**ACCESSION NUMBER**: 0001062993-23-004752

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20230222

**FILED AS OF DATE**: 20230224

**DATE AS OF CHANGE**: 20230224

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Splaine Thomas Jr
- **CENTRAL INDEX KEY:** 0001339736

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 000-17820
- **FILM NUMBER:** 23666067

**MAIL ADDRESS:**
- **STREET 1:** 101 JFK PARKWAY
- **CITY:** SHORT HILLS
- **STATE:** NJ
- **ZIP:** 07078
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** LAKELAND BANCORP INC
- **CENTRAL INDEX KEY:** 0000846901
- **STANDARD INDUSTRIAL CLASSIFICATION:** STATE COMMERCIAL BANKS [6022]
- **IRS NUMBER:** 222953275
- **STATE OF INCORPORATION:** NJ
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** 250 OAK RIDGE RD
- **CITY:** OAK RIDGE
- **STATE:** NJ
- **ZIP:** 07438
- **BUSINESS PHONE:** 9736972000

**MAIL ADDRESS:**
- **STREET 1:** 250 OAK RIDGE RD
- **CITY:** OAKRIDGE
- **STATE:** NJ
- **ZIP:** 07438

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## FORM 4

### STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

[ ] Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>Splaine Thomas Jr<br><sub>(Last) (First) (Middle)</sub><br>C/O LAKELAND BANCORP, INC.<br>250 OAK RIDGE ROAD<br><sub>(Street)</sub><br>OAK RIDGE, NJ 07438<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-02-22 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director [ ] 10% Owner<br>[X] Officer (give title below) [ ] Other (specify below)<br>_EVP and CFO_ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>LAKELAND BANCORP INC [ LBAI ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[X] Form filed by One Reporting Person<br>[ ] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | 3. Transaction Code (V) | 3. Transaction Code (V) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | Code | V | Amount | (A) or (D) | Price | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| Common Stock | 2023-02-22 |  | A |  | 7859<sup>(1)</sup> | A | $0.00 | 87344 | D |  |
| Common Stock | 2023-02-22 |  | A |  | 7859<sup>(2)</sup> | A | $0.00 | 95203 | D |  |

---

## Table II - Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | 4. Transaction Code (V) | 4. Transaction Code (V) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Underlying Securities | 7. Title and Amount of Underlying Securities | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |

---

### Footnotes:

(1) The above transaction represents the Executive's 2023 Incentive Plan award. The award is time-based Restricted Stock Units (RSUs) issued under the Issuer's 2018 Omnibus Equity Incentive Plan (Plan) and represent the right to receive, following vesting, one share of common stock.  One-third (1/3rd) of the time-based RSUs shall become vested on February 27 of each of the following three years provided that the Executive remains in Continuous Service (as defined in the Plan) through each respective anniversary/vesting date. If such Continuous Service terminates sooner, the RSUs will be forfeited unless such termination of Continuous Service occurs because of death, disability, normal or early retirement, or a change in control event.

(2) The above transaction represents the Executive's 2023 Incentive Plan award. The award is Performance-Based Stock Units issued under the Issuer's 2018 Omnibus Equity Incentive Plan and represent the right to receive, following vesting, one share of common stock.  The performance-based award is subject to goals based on the Company's return on average equity and may be adjusted upward or downward based on the Company's total shareholder return as compared to the TSR of the median of the Peer Group during the performance period. The PSUs shall become vested on February 27, 2025 provided that the Executive remains in Continuous Service through the vesting date. If such Continuous Service terminates sooner, the PSUs will be forfeited unless such termination of Continuous Service occurs because of death, disability, normal or early retirement, or a change in control event. Includes 58,524 Restricted and Performance Stock Units that have not yet vested.

**Signature:** /s/ Patricia Backman, POA  
**Date:** 2023-02-24

### Remarks:

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.**