0001214659-23-007855.txt : 20230526
0001214659-23-007855.hdr.sgml : 20230526
20230526110308
ACCESSION NUMBER: 0001214659-23-007855
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230525
FILED AS OF DATE: 20230526
DATE AS OF CHANGE: 20230526
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Middleton Daina
CENTRAL INDEX KEY: 0001620476
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38873
FILM NUMBER: 23964528
MAIL ADDRESS:
STREET 1: C/O MARIN SOFTWARE INCORPORATED
STREET 2: 123 MISSION STREET, 25TH FLOOR
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94105
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Palomar Holdings, Inc.
CENTRAL INDEX KEY: 0001761312
STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 7979 IVANHOE AVENUE
STREET 2: SUITE 500
CITY: LA JOLLA
STATE: CA
ZIP: 92037
BUSINESS PHONE: 619-567-5290
MAIL ADDRESS:
STREET 1: 7979 IVANHOE AVENUE
STREET 2: SUITE 500
CITY: LA JOLLA
STATE: CA
ZIP: 92037
FORMER COMPANY:
FORMER CONFORMED NAME: GC Palomar Holdings
DATE OF NAME CHANGE: 20181211
4
1
marketforms-61632.xml
PRIMARY DOCUMENT
X0407
4
2023-05-25
0001761312
Palomar Holdings, Inc.
PLMR
0001620476
Middleton Daina
7979 IVANHOE AVENUE
SUITE 500
LA JOLLA
CA
92037
true
false
false
false
0
Common Stock
2023-05-25
4
A
false
1639
0
A
4266
D
The amount reported reflects Restricted Stock Units (RSUs) granted to the Reporting Person pursuant to Issuer's 2019 Equity Incentive Plan. Subject to the Reporting Person's continued service, the RSUs shall vest in full upon the first anniversary of the Grant Date.
Each restricted stock unit represents a contingent right to receive one share of the Issuer's common stock.
/s/ Angela Grant, Attorney-in-Fact
2023-05-25