0001547903-22-000093.txt : 20220511
0001547903-22-000093.hdr.sgml : 20220511
20220511161820
ACCESSION NUMBER: 0001547903-22-000093
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220510
FILED AS OF DATE: 20220511
DATE AS OF CHANGE: 20220511
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Pollitzer Adam
CENTRAL INDEX KEY: 0001706001
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36174
FILM NUMBER: 22913968
MAIL ADDRESS:
STREET 1: 2100 POWELL STREET
STREET 2: 12TH FLOOR
CITY: EMERYVILLE
STATE: CA
ZIP: 94608
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: NMI Holdings, Inc.
CENTRAL INDEX KEY: 0001547903
STANDARD INDUSTRIAL CLASSIFICATION: SURETY INSURANCE [6351]
IRS NUMBER: 454914248
STATE OF INCORPORATION: CA
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 2100 POWELL STREET, 12TH FLOOR
CITY: EMERYVILLE
STATE: CA
ZIP: 94608
BUSINESS PHONE: (855) 530-6642
MAIL ADDRESS:
STREET 1: 2100 POWELL STREET, 12TH FLOOR
CITY: EMERYVILLE
STATE: CA
ZIP: 94608
4
1
wf-form4_165230028581733.xml
FORM 4
X0306
4
2022-05-10
0
0001547903
NMI Holdings, Inc.
NMIH
0001706001
Pollitzer Adam
C/O NMI HOLDINGS, INC.
2100 POWELL ST., 12TH FLOOR
EMERYVILLE
CA
94608
1
1
0
0
Chief Executive Officer
Class A Common Shares, $0.01 par value per share
2022-05-10
4
F
0
18363
0
D
139354
D
Represents shares withheld by NMIH to to satisfy withholding taxes due in connection with the vesting of certain restricted stock units granted to the reporting person on May 10, 2017, at a net settlement price equal to the closing stock price on May 10, 2022. Such restricted stock units vest in five equal annual installments beginning on May 10, 2018.
Represents 63,262 class A common shares and 76,092 unvested restricted stock units.
/s/ Lynn Zheng, as Attorney-in-Fact
2022-05-11