0000950103-21-011660.txt : 20210730
0000950103-21-011660.hdr.sgml : 20210730
20210730205751
ACCESSION NUMBER: 0000950103-21-011660
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210728
FILED AS OF DATE: 20210730
DATE AS OF CHANGE: 20210730
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Zames Matthew E
CENTRAL INDEX KEY: 0001550416
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39754
FILM NUMBER: 211134321
MAIL ADDRESS:
STREET 1: 101 MISSION ST.
STREET 2: SUITE 740
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94105
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
dp155511_4-zames.xml
FORM 4
X0306
4
2021-07-28
0
0001722438
Doma Holdings, Inc.
DOMA
0001550416
Zames Matthew E
101 MISSION ST. SUITE 740
SAN FRANCISCO
CA
94105
1
0
0
0
Common Stock
2021-07-28
4
A
0
376416
A
376416
I
By Matthew E. Zames Family, LLC
Common Stock
2021-07-28
4
A
0
376422
A
376422
I
By Jill E. Zames Family, LLC
Received in exchange for shares of common stock of Doma Holdings, Inc., which was formerly known as States Title Holding, Inc. ("Former Doma") in connection with the merger by and among Capitol Investment Corp V., Capitol V Merger Sub, Inc. and Former Doma (the "Merger").
/s/ Christian Ameri, as Attorney-in-Fact for Matthew E. Zames
2021-07-30