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