0001722438-21-000064.txt : 20211115
0001722438-21-000064.hdr.sgml : 20211115
20211115162434
ACCESSION NUMBER: 0001722438-21-000064
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211111
FILED AS OF DATE: 20211115
DATE AS OF CHANGE: 20211115
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Smith Michael Alan
CENTRAL INDEX KEY: 0001543844
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39754
FILM NUMBER: 211411100
MAIL ADDRESS:
STREET 1: C/O CAPITALSOURCE INC.
STREET 2: 5404 WISCONSIN AVENUE, 2ND FLOOR
CITY: CHEVY CHASE
STATE: MD
ZIP: 20815
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Doma Holdings, Inc.
CENTRAL INDEX KEY: 0001722438
STANDARD INDUSTRIAL CLASSIFICATION: TITLE INSURANCE [6361]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 101 MISSION STREET
STREET 2: SUITE 740
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94105
BUSINESS PHONE: (650) 419-3827
MAIL ADDRESS:
STREET 1: 101 MISSION STREET
STREET 2: SUITE 740
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94105
FORMER COMPANY:
FORMER CONFORMED NAME: Capitol Investment Corp. V
DATE OF NAME CHANGE: 20171113
4
1
wf-form4_163701145341683.xml
FORM 4
X0306
4
2021-11-11
0
0001722438
Doma Holdings, Inc.
DOMA
0001543844
Smith Michael Alan
101 MISSION ST.
SUITE 740
SAN FRANCISCO
CA
94105
0
1
0
0
Chief Accounting Officer
Common stock
2021-11-11
4
P
0
14400
7.10
A
144271
D
/s/ Christian Ameri, as Attorney-in-Fact for Michael Alan Smith
2021-11-15