0000950103-21-011664.txt : 20210730 0000950103-21-011664.hdr.sgml : 20210730 20210730210444 ACCESSION NUMBER: 0000950103-21-011664 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: Ahmad Noaman CENTRAL INDEX KEY: 0001874802 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39754 FILM NUMBER: 211134331 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 dp155508_4-ahmad.xml FORM 4 X0306 4 2021-07-28 0 0001722438 Doma Holdings, Inc. DOMA 0001874802 Ahmad Noaman 101 MISSION ST. SUITE 740 SAN FRANCISCO CA 94105 0 1 0 0 Chief Financial Officer Common Stock 2021-07-28 4 A 0 853001 A 853001 D Stock Options (Right to Buy) 0.45 2021-07-28 4 A 0 1148724 A 2029-04-15 Common stock 1148724 1148724 D Stock Options (Right to Buy) 0.71 2021-07-28 4 A 0 89923 A 2030-06-02 Common stock 89923 89923 D Stock Options (Right to Buy) 0.71 2021-07-28 4 A 0 308655 A 2030-09-21 Common stock 308655 308655 D 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"). The option vests in 25% on the first anniversary of December 10, 2018 and in equal monthly installments thereafter until it is fully vested on the fourth anniversary of such date. The stock option was received in the Merger in exchange for a stock option to acquire shares of Former Doma common stock. The option vests in 25% on the first anniversary of March 1, 2020 and in equal monthly installments thereafter until it is fully vested on the fourth anniversary of such date. The stock option was received in the Merger in exchange for a stock option to acquire shares of Former Doma common stock. The option vests in equal monthly installments beginning on September 1, 2020 until it is fully vested on March 1, 2025. The stock option was received in the Merger in exchange for a stock option to acquire shares of Former Doma common stock. /s/ Christian Ameri, as Attorney-in-Fact for Noaman Ahmad 2021-07-30