Statement of Changes in Beneficial Ownership (4)
January 19 2023 - 04:40PM
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).
|
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL
OWNERSHIP OF SECURITIES
|
OMB
APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response... 0.5 |
|
Filed pursuant to Section 16(a) of the
Securities Exchange Act of 1934 or Section 30(h) of the Investment
Company Act of 1940
|
|
1. Name
and Address of Reporting Person *
Simkoff Maxwell |
2. Issuer Name and Ticker or Trading
Symbol Doma Holdings, Inc. [ DOMA ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)__X__
Director __X__
10% Owner
__X__ Officer (give title
below) _____ Other
(specify below)
Chief Executive Officer |
(Last)
(First)
(Middle)
101 MISSION ST., SUITE 740 |
3. Date of Earliest Transaction (MM/DD/YYYY)
1/17/2023
|
(Street)
SAN FRANCISCO, CA 94105
(City)
(State)
(Zip)
|
4. If Amendment, Date Original Filed
(MM/DD/YYYY)
|
6. Individual or Joint/Group Filing
(Check Applicable Line) ___
Form filed by One Reporting Person
_ X _ 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 |
1/17/2023 |
|
S |
|
26387 (1) |
D |
$0.544 (2) |
46276820 (3) |
I |
By The Saslaw-Simkoff Revocable
Trust |
Common stock |
1/18/2023 |
|
S |
|
33483 (1) |
D |
$0.524 (4) |
46243337 (3) |
I |
By The Saslaw-Simkoff Revocable
Trust |
Common stock |
|
|
|
|
|
|
|
5219014 |
D |
|
Common stock |
|
|
|
|
|
|
|
346609 (5) |
I |
By Max Simkoff 2020 GRAT |
Common stock |
|
|
|
|
|
|
|
346609 (6) |
I |
By Jennifer Saslaw 2020
GRAT |
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) |
This transaction was made
pursuant to a Rule 10b5-1 trading plan adopted by the reporting
person on May 13, 2022. |
(2) |
The price reported above in
Column 4 represents a weighted average sales price. This
transaction was executed in multiple trades at prices ranging from
$0.53 to $0.56, inclusive. The reporting person hereby undertakes
to provide, upon request, to Doma Holdings, Inc. (the "Issuer"),
any security holder of the Issuer, or the staff of the Securities
and Exchange Commission, full information regarding the number of
shares and prices at which the transaction was
effected. |
(3) |
These shares are owned
directly by The Saslaw-Simkoff Revocable Trust and indirectly by
Maxwell Simkoff as trustee of the trust. The reporting person
disclaims beneficial ownership except to the extent of his
pecuniary interest therein. |
(4) |
The price reported above in
Column 4 represents a weighted average sales price. This
transaction was executed in multiple trades at prices ranging from
$0.51 to $0.55, inclusive. The reporting person hereby undertakes
to provide, upon request, to the Issuer, any security holder of the
Issuer, or the staff of the Securities and Exchange Commission,
full information regarding the number of shares and prices at which
the transaction was effected. |
(5) |
These shares are owned
directly by the Max Simkoff 2020 GRAT. The reporting person
disclaims beneficial ownership except to the extent of his
pecuniary interest therein. |
(6) |
These shares are held for
the benefit of the reporting person's wife. The reporting person
disclaims beneficial ownership of these shares except to the extent
of his pecuniary interest therein. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
Simkoff Maxwell
101 MISSION ST.
SUITE 740
SAN FRANCISCO, CA 94105 |
X |
X |
Chief Executive Officer |
|
Saslaw-Simkoff Revocable Trust
101 MISSION ST.
SUITE 740
SAN FRANCISCO, CA 94105 |
|
X |
|
|
Signatures
|
/s/ Christian Ameri, as Attorney-in-Fact for
Maxwell Simkoff |
|
1/19/2023 |
**Signature of
Reporting Person |
Date |
/s/ Christian Ameri, as Attorney-in-Fact for
Maxwell Simkoff, Trustee |
|
1/19/2023 |
**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. |
Capitol Investment Corp V (NYSE:CAP)
Historical Stock Chart
From Feb 2023 to Mar 2023
Capitol Investment Corp V (NYSE:CAP)
Historical Stock Chart
From Mar 2022 to Mar 2023