Statement of Changes in Beneficial Ownership (4)
August 22 2022 - 05:01PM
Edgar (US Regulatory)
FORM 4
[ ] Check this box if no longer subject to Section
16. Form 4 or Form 5 obligations may continue. See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL
OWNERSHIP OF SECURITIES
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OMB
APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response... 0.5 |
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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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1. Name
and Address of Reporting Person * Smith
Michael Alan |
2. Issuer Name and Ticker or Trading
Symbol Doma Holdings, Inc. [ DOMA ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)_____
Director _____
10% Owner
__X__ Officer (give title
below) _____ Other
(specify below)
Chief Financial Officer |
(Last)
(First)
(Middle)
101 MISSION ST., SUITE 740 |
3. Date of Earliest Transaction (MM/DD/YYYY)
8/18/2022
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(Street)
SAN FRANCISCO, CA 94105
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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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. Trans. Date |
2A. Deemed Execution Date, if any |
3. Trans. 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 |
8/18/2022 |
|
S |
|
13462 (1) |
D |
$0.851 (2) |
1012432 |
D |
|
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible
securities)
|
1. Title of Derivate Security
(Instr. 3) |
2. Conversion or Exercise Price of Derivative
Security |
3. Trans. Date |
3A. Deemed Execution Date, if any |
4. Trans. 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 |
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 of Derivative Security: 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 |
Explanation of
Responses: |
(1) |
As previously reported, on
October 6, 2021, the reporting person was granted 129,871
restricted stock units ("RSUs") under the Doma Holdings, Inc.'s
(the "Company") Omnibus Incentive Plan (the "Plan"), representing
the right to receive shares of Company common stock in the future.
The "Vesting Commencement Date" of the grant was August 16, 2021,
and the grant vests as follows: 25% of the RSUs vest on the first
anniversary of the Vesting Commencement Date and the remainder vest
in 12 consecutive, equal, quarterly installments such that the
award is fully vested on the fourth anniversary of the Vesting
Commencement Date; provided the reporting person is continuously
employed through such date as applicable. On August 16, 2022,
32,467 shares of such RSUs vested. In connection with this vesting,
13,462 shares were sold on August 18, 2022 to satisfy the reporting
person's tax withholding obligations. |
(2) |
The price reported above in
Column 4 represents a weighted average sales price of. This
transaction was executed in multiple trades at prices ranging from
$0.82 to $0.87, inclusive. The reporting person hereby undertakes
to provide, upon request, to the Company, any security holder of
the Company, or the staff of the Securities and Exchange
Commission, full information regarding the number of shares and
prices at which the transaction was effected. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
Smith Michael Alan
101 MISSION ST.
SUITE 740
SAN FRANCISCO, CA 94105 |
|
|
Chief Financial Officer |
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Signatures
|
/s/ Christian Ameri, as Attorney-in-Fact for
Michael Alan Smith |
|
8/22/2022 |
**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 control number. |
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