0001214659-24-009936.txt : 20240524 0001214659-24-009936.hdr.sgml : 20240524 20240524161926 ACCESSION NUMBER: 0001214659-24-009936 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240523 FILED AS OF DATE: 20240524 DATE AS OF CHANGE: 20240524 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Fallon Catriona M. CENTRAL INDEX KEY: 0001649289 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38873 FILM NUMBER: 24984640 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] ORGANIZATION NAME: 02 Finance 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-66032.xml PRIMARY DOCUMENT X0508 4 2024-05-23 0001761312 Palomar Holdings, Inc. PLMR 0001649289 Fallon Catriona M. 7979 IVANHOE AVENUE, SUITE 500 LA JOLLA CA 92037 true false false false 0 Common Stock 2024-05-23 4 A false 1224 0 A 6058 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 earlier to occur of (1) the first anniversary of the Grant Date or (2) the next annual meeting of stockholders of the Company. Each restricted stock unit represents a contingent right to receive one share of the Issuer's common stock. /s/ Angela Grant, Attorney-in-Fact 2024-05-24