0000950103-21-011666.txt : 20210730 0000950103-21-011666.hdr.sgml : 20210730 20210730211148 ACCESSION NUMBER: 0000950103-21-011666 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: Summers Lawrence Henry CENTRAL INDEX KEY: 0001626636 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39754 FILM NUMBER: 211134338 MAIL ADDRESS: STREET 1: JOHN F. KENNEDY SCHOOL OF GOVERNMENT STREET 2: MAILBOX 8, 79 JFK STREET CITY: CAMBRIDGE STATE: MA ZIP: 02138 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 dp155509_4-summers.xml FORM 4 X0306 4 2021-07-28 0 0001722438 Doma Holdings, Inc. DOMA 0001626636 Summers Lawrence Henry 101 MISSION ST. SUITE 740 SAN FRANCISCO CA 94105 1 0 0 0 Common Stock 2021-07-28 4 A 0 537170 A 537170 D Common Stock 2021-07-28 4 A 0 692889 A 692889 I By LHSummers Economic Consulting 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, Attorney-in-Fact for Lawrence Summers 2021-07-30