0001209191-23-035096.txt : 20230607 0001209191-23-035096.hdr.sgml : 20230607 20230607163853 ACCESSION NUMBER: 0001209191-23-035096 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230605 FILED AS OF DATE: 20230607 DATE AS OF CHANGE: 20230607 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: 23999495 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 2023-06-05 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 Restricted Stock Units 2023-06-05 4 A 0 5709 0.00 A 2024-06-05 Common Stock 5709 5709 D Restricted stock units convert into common stock on a one-for-one basis. Represents time-based restricted stock units granted on June 5, 2023 pursuant to the annual equity grant under DoubleVerify Holdings, Inc.'s non-employee director compensation program. The restricted stock units vest on the earlier of (i) June 5, 2024 and (ii) the date of DoubleVerify Holdings, Inc.'s 2024 Annual Meeting of Stockholders, subject to Ms. List's continued services. /s/ Andrew E. Grimmig, as Attorney-in-Fact for Teri L. List 2023-06-07