0001437749-23-022166.txt : 20230804 0001437749-23-022166.hdr.sgml : 20230804 20230804165551 ACCESSION NUMBER: 0001437749-23-022166 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230803 FILED AS OF DATE: 20230804 DATE AS OF CHANGE: 20230804 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Simkoff Maxwell CENTRAL INDEX KEY: 0001868802 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39754 FILM NUMBER: 231144714 MAIL ADDRESS: STREET 1: 101 MISSION ST. STREET 2: SUITE 740 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Saslaw-Simkoff Revocable Trust CENTRAL INDEX KEY: 0001875424 STATE OF INCORPORATION: CA FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39754 FILM NUMBER: 231144713 BUSINESS ADDRESS: STREET 1: 101 MISSION ST. STREET 2: SUITE 740 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 BUSINESS PHONE: 703-789-5646 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 rdgdoc.xml SIMKOFF_MAXWELL_2023-08-03 X0508 4 2023-08-03 0001722438 Doma Holdings, Inc. DOMA 0001868802 Simkoff Maxwell 101 MISSION ST. SUITE 1050 SAN FRANCISCO CA 94105 1 1 1 Chief Executive Officer 0001875424 Saslaw-Simkoff Revocable Trust 101 MISSION ST. SUITE 1050 SAN FRANCISCO CA 94105 1 0 Common stock 2023-08-03 4 A 0 135000 0 A 337255 D Common stock 1801350 I The Saslaw-Simkoff Revocable Trust Common stock 28235 I Maxwell Simkoff 2023 GRAT Common stock 28235 I Jennifer Saslaw 2023 GRAT Grant of Doma Holdings, Inc.'s (the "Company") common stock to the reporting person in the form of restricted stock units ("RSUs") pursuant to the Company's Omnibus Incentive Plan (the "Plan"). The "Vesting Commencement Date" is August 3, 2023. These RSUs will be settled solely by delivery of shares of Company common stock and vest as follows: 50% of the RSUs will vest on the six-month anniversary of the Vesting Commencement Date and the remainder will vest in 4 consecutive, equal, quarterly installments such that the award is fully vested on the 18-month anniversary of the Vesting Commencement Date, provided the reporting person is continuously employed through such date as applicable. These shares are owned directly by The Saslaw-Simkoff Revocable Trust and indirectly by Maxwell Simkoff as trustee of the trust. The reporting person disclaims beneficial ownership except to the extent of his pecuniary interest therein. These shares are owned directly by the Maxwell Simkoff 2023 GRAT. The reporting person disclaims beneficial ownership except to the extent of his pecuniary interest therein. These shares are held for the benefit of the reporting person's wife. The reporting person disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein. /s/ Christian Ameri, as Attorney-in-Fact for Maxwell Simkoff 2023-08-04 /s/ Christian Ameri, as Attorney-in-Fact for Maxwell Simkoff, Trustee 2023-08-04