0001209191-23-034237.txt : 20230605 0001209191-23-034237.hdr.sgml : 20230605 20230605160235 ACCESSION NUMBER: 0001209191-23-034237 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230601 FILED AS OF DATE: 20230605 DATE AS OF CHANGE: 20230605 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: List Teri CENTRAL INDEX KEY: 0001529370 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40349 FILM NUMBER: 23992400 MAIL ADDRESS: STREET 1: 2200 PENNSYLVANIA AVENUE STREET 2: SUITE 800W CITY: WASHINGTON STATE: DC ZIP: 20037 FORMER NAME: FORMER CONFORMED NAME: List-Stoll Teri DATE OF NAME CHANGE: 20180306 FORMER NAME: FORMER CONFORMED NAME: List Teri L. DATE OF NAME CHANGE: 20110907 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: DoubleVerify Holdings, Inc. CENTRAL INDEX KEY: 0001819928 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROGRAMMING, DATA PROCESSING, ETC. [7370] IRS NUMBER: 822714562 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 462 BROADWAY CITY: NEW YORK STATE: NY ZIP: 10013 BUSINESS PHONE: 212-631-2111 MAIL ADDRESS: STREET 1: 462 BROADWAY CITY: NEW YORK STATE: NY ZIP: 10013 4 1 doc4.xml FORM 4 SUBMISSION X0407 4 2023-06-01 0 0001819928 DoubleVerify Holdings, Inc. DV 0001529370 List Teri C/O DOUBLEVERIFY HOLDINGS, INC. 462 BROADWAY NEW YORK NY 10013 1 0 0 0 0 Common Stock 2023-06-01 4 M 0 9183 0.00 A 59508 D Restricted Stock Units 2023-06-01 4 M 0 9183 0.00 D 2023-06-01 Common Stock 9183 0 D Each restricted stock unit ("RSU") was granted on June 15, 2022 and represents a right to receive one share of common stock on a one-to-one basis. The RSUs fully vested on June 1, 2023. Restricted stock units convert into common stock on a one-for-one basis. /s/ Andrew E. Grimmig, as Attorney-in-Fact for Teri L. List 2023-06-05